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2 (FORM 2 - Public filing) <br />RANGE (write number and check direction) R East West <br />QUARTER SECTION (check one):NE NW SE SW <br />QUARTER/QUARTER SECTION (check one): NE NW SE SW <br />DESCRIPTION: (the number of les and direction to the nearest town and the approximate elevation): <br />NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or as supplemental information to <br />this NOI. GPS measurements will be acceptable for this purpose: �ber � &&x 6ft) n t s A "1 f a'-1d !Jllj <br />4150 CJNOA, -C lrful;nn he T n no►.► anel LAIV .►Ah, A 11A A1.4 A.AJ'9�e V-04/ <br />11. LAND SORSMP Private Public Domain (BL National Forest (USFS) <br />State tate Sovereign Lands Other (please describe): <br />If prospecting is located on BLM or USFS land the remaining section must be completed, <br />otherwise go to section II Maps & Drawings <br />12. PROSPECTING ON BUREAU OF LAND MANAGEMENT (BLV) LAND AND U.S. FOREST SERVICE (USFS) <br />LAND <br />The Division and the BLM/USFS have entered into cooperative agreements that eliminate the need for a prospector to post a <br />financial warranty with each agency and allow them to coordinate the review of the NOI in order to minimise administrative <br />processing time and effort. <br />G. CLAIMANT: <br />Name: <br />Address: - -/� y� �/ S � i ✓WGi�. ,1) ;, <br />t11 k- <br />Telephone: 0i 1 i – 10 13 <br />Fax Number: <br />H. SITE/CLAIM INFORMATION: <br />List names, serial numbers and provide legal description to nearest quarter - quarter section of all sites or claims (attach <br />additional page, if necessary). <br />NAME SERIAL NUMBER n LEGAL DESCRIPTION ff ( /'! 4 l a �j <br />S °7 d 4 l , ACV 10Ill <br />