Dec. 29.] THE NEW ZEALAND GAZETTE. 1479

SCHEDULE 35 (Sec. 84, “The Mining Act, 1891”).
APPLICATION FOR AUTHORITY TO DISCHARGE DÉBRIS ON, OR TO CONVEY THE SAME OVER, OCCUPIED OR UNOCCUPIED GROUND.
No. .
To the Warden at .
I hereby give notice that I desire to obtain authority to discharge débris upon [or to convey débris over] an adjacent claim [or unoccupied ground adjoining my claim as hereunder specified], at , and I desire to obtain permission to occupy thereon an area of for the discharge of such débris.
Dated at , the day of , 18 .
Name of adjacent claim:
Signature of applicant:
Number of miner’s right:
Any person having any objection to this application must lodge the same in writing at the Warden’s office at within seven days from the date hereof.
[Date.] Warden.

SCHEDULE 36 (Sec. 84, “The Mining Act, 1891”).
CERTIFICATE OF AUTHORITY TO CONVEY OR DISCHARGE DÉBRIS ON TO OR OVER GROUND.
No. .
I HEREBY certify that has received authority to discharge débris upon [or to convey débris over] , and to occupy thereon sufficient space for the discharge of such débris. [State conditions, if any.]
Dated at , this day of , 18 . Warden.

SCHEDULE 37 (Reg. 251).
No. .
MEMORIAL FOR REGISTRATION OF CLAIM OR RIGHT, TO BE PRESENTED IN DUPLICATE TO THE REGISTRAR, WHO SHALL SIGN AND RETURN ONE COPY THEREOF.

[Signature of person applying for registration.]
Registered
Dated at , this day of , 18 .
[No. and date of miner’s right.] Registrar.

SCHEDULE 38 (Regs. 253 and 254).
MEMORANDUM OF ASSIGNMENT.
No. , Part I. | No. , Part II.
Assignment or transfer— | Memo. of Assignment.
Date of registration: | Mining Registrar’s Office, , 18 .
Particulars— | I have this day registered a document exhibited to me by , purporting to be an assignment of , of which the particulars are as follows:
Name in full, address, and occupation of assignor: | Name of assignor:
Name in full, address, and occupation of assignee: | Name of assignee:
Date of assignment: | Date of assignment:
Nature of property assigned: | Amount of consideration:
Interest therein assigned: | Nature of property assigned:
Reference to folio of register: | Interest assigned therein:
Fees received: | Reference to folio of register:
Fees received:
[Signature of Assignee,} | Mining Registrar.
or Agent presenting} |
Assignment.] |
[Original documents to be retained and filed on record.]

SCHEDULE 39 (Regs. 252 and 258).
MEMORIAL OF ENCUMBRANCE.
To be presented in duplicate, and one copy signed and returned by Registrar.
No. .

[Date of memorial.] [Signature of grantor of encumbrance.]
[Signature of grantee of encumbrance.]
Registered [Signature of Registrar.]
[Date.]

SCHEDULE 40 (Reg. 259).
DISCHARGE OF ENCUMBRANCE.
No. .
To the Mining Registrar,
Take notice that Encumbrance No. , upon the interest of in the claim, has been satisfied and discharged this day of , 18 .
[Signature of grantee of encumbrance.]
[Date of registration.] Registrar.

SCHEDULE 41 (Regs. 36, 57, 66, and 226).
SCALE OF FEES FOR SURVEY.
THERE shall be paid for the survey of any area as follows:—
Not exceeding 30 acres, 4s. per acre, but not less than £5.
Exceeding 30 and up to 50 acres, 3s. 6d. per acre, but not less than £6.
Exceeding 50 and up to 100 acres, 3s. per acre, but not less than £8 15s.
Exceeding 100 and up to 200 acres, 2s. 6d. per acre, but not less than £15.
Extended claims, £2 10s. each.
Travelling-expenses, 3s. per mile one way.
Bush-cutting, 2s. 6d. per chain.
Underground surveys, encroachments, water-races, or other surveys to which the foregoing rates do not apply, shall be paid for as follows:—
Surveyor’s fee, £1 10s. per day or part of a day.
Labour extra.
Mileage, 3s. per mile one way.

SCHEDULE 42 (Regs. 261 and 263).
APPLICATION FOR PERMISSION TO CUT TIMBER.
To the Warden at
hereby make application for permission to cut timber on acres of Crown lands within the district of , for [Here state the purpose], and I herewith enclose a true description of the land applied for.
Dated at , the day of , 18 . [Signature.]
Number and Date of Miner’s Right:
Any person having any objection to this application must lodge the same in writing at the Warden’s office at within seven days from the date hereof.
[Date.] Warden.

SCHEDULE 43 (Regs. 261 and 263).
SAW-MILL TIMBER CERTIFICATE.
No. .
I HEREBY certify that has received permission to cut timber (except kauri or reserved trees) over an area of acres, as described on the back hereof, within the District of for the period of months from the date hereof [subject to all Native rights during the currency of this certificate].
Dated at , the day of , 18 . Warden.