Jan. 17.] THE NEW ZEALAND GAZETTE. 285

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Form 17 (Reg. 33).

Under “The Mining Act, 1905.”

APPLICATION FOR LICENSE FOR A TAIL-RACE [or MAIN TAIL-RACE.]

[As in Form 16, with all necessary modifications, including Schedule as follows.]

Locality of the race, and of its starting and terminal points :
Length and intended course of race :
Its greatest depth and breadth :
Estimated time and cost of construction :
Proposed term of license :
[If a main tail-race.] The persons by whom and the terms upon which the race is to be used :

Form 18 (Reg. 33).

Under “The Mining Act, 1905.”

APPLICATION FOR LICENSE FOR A DAM.

[As in Form 15, with all necessary modifications, including Schedule as follows.]

SCHEDULE.

Locality of dam :
Particulars of dam, viz. :—
Length of dam-wall
Greatest height of same :
Breadth of same at base :
Length and width of water-area :
Estimated time and cost of construction :
Proposed term of license :
Purpose for which water is to be stored :

Form 19 (Reg. 33).

Under “The Mining Act, 1905.”

APPLICATION FOR LICENSE FOR RESIDENCE-SITE [or BUSINESS-SITE].

[As in Form 15, with all necessary modifications, including Schedule as follows.]

SCHEDULE.

Locality where land is situate, with its boundaries, measurements, and area :
Proposed term of license :

Form 20 (Reg. 33.)

Under “The Mining Act, 1905.”

APPLICATION FOR LICENSE FOR A SPECIAL SITE.

[As in Form 15, with all necessary modifications, including Schedule as follows.]

SCHEDULE.

Locality where special site is situate, with its boundaries, measurements, and area :
Purpose for which special site is to be used :
Claim in connection with which the special site is to be used :
Proposed term of license :

Form 20A (Reg. 33).

Under “The Mining Act, 1905.”

APPLICATION FOR A MINERAL LICENSE.

[As in Form 15, with all necessary modifications, including Schedule as follows.]

SCHEDULE.

Locality where license is situate, with its boundaries, measurements, and area.

Form No. 21 (Reg. 33).

Under “The Mining Act, 1905.”

APPLICATION TO SURRENDER MINING PRIVILEGE[S] ABSOLUTELY.

To the Warden of the Mining District, at .

Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], being the holder of the mining privilege[s] specified in the Schedule hereto, hereby applies to surrender the same absolutely, and not for the purpose of exchange.

Address for service :
Dated at , this day of , 19 .

SCHEDULE.

[Signature of applicant, &c.]

Precise time, &c.

Form 22 (Reg. 33).

Under “The Mining Act, 1905.”

APPLICATION FOR EXCHANGE FOR TITLE UNDER “THE MINING ACT, 1905.”

To the Warden of the Mining District, at .

Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], being the holder of the mining privilege specified in the Schedule hereto, hereby applies to surrender the same, and to obtain in substitution therefor a license for a corresponding mining privilege under that Act.

Address for service :
Dated at , this day of , 19 .

SCHEDULE.

Name of mining privilege proposed to be surrendered, and the Act under which the title is held :
Locality and area of mining privilege :
Existing instrument of title, with date and registered number :
Whether instrument produced or not :
Time from which priority is claimed :
Name of proposed corresponding mining privilege :
Proposed term of new license :

[Signature of applicant, &c.]

Precise time, &c.

Form 23 (Reg. 33).

Under “The Mining Act, 1905.”

APPLICATION FOR AMALGAMATION OF CLAIMS.

To the Warden of the Mining District, at .

Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], being the holder of the claims specified in the Schedule hereto, and being desirous of facilitating the working thereof, and simplifying the titles thereto, hereby applies to surrender the same, and to obtain in substitution therefor a license for an amalgamated claim.

Address for service :
Dated at , this day of , 19 .