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RECEIVED <br />L APR 14 2015 <br />�- DIVISION OF RECLAMATION <br />MINING AND SAFETY <br />Form 1 — All information for DRMS use and confidential filing <br />NOTICE OF INTENT TO CONDUCT PROSPECTING OPERATIONS <br />FOR HARD ROCK/METAL MINES <br />CHECK ONE_ There is an NOI Number Already Assigned to this Operation <br />NOI tf P ---�ZC/5- Gass (Please reference the file number assigned to this operation) <br />� New NOI <br />Modification to an Existing NOI <br />NOW P- - _ (Provide for Modifications to an existing NOp <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described below. <br />I. GENERAL INFORMATION <br />1. DATE NOI RECEIVED BY THE DIVISION: _ _ (office use only) <br />2. PROJECT NAME: di S / /V1, i1 i i7 <br />3. PROSPECTOR: PERSON MLRB SHOULD CONTACT: <br />rtL, Name: - _ (`t �'r � ✓� s f- Name: <br />'rifle: _ /4'1,& <br />Company Name: _ <br />Street: —I `� 9 j�^•t. I Crete k )� d. <br />P.O. Box: <br />City: a k -ic c <br />State: CD <br />Zip Code: g o 3 2.7 <br />— <br />Telephone Number: ( 7 t <br />T <br />Fax Number: <br />Title: <br />Company Name: <br />Street: 2 Z v ce d a He� D r. <br />P.O. Box: _ <br />City: p l© 5! <br />State: C U <br />Zip Code: i�y )G y <br />Telephone Number: Y`/%y <br />Fax Number: <br />4. APPLICATION_ FEE: SW ('�iOLS require a $86 fee which must accompany this notice or it cannot be processed by the <br />Division). <br />5. LOCATION INFOWNIATION: <br />County: r <br />PRINNCIPAI. MERIDAN (check one) <br />SECTION (write number), <br />See a fI-eiC/rd C / «:� /•`sf.'�r� <br />i< _60' (Colorado) _ -- l (New Mexico) -- J' <br />5 <br />