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2 (FORM 2 - Public filing) <br />43 MmT-H <br />RANGE (write number and check direction) R East West <br />QUARTER SECTION (check one):_D_NENW SE SW <br />QUARTER/QUARTER SECTION (check one): _NE jj W SE aSW <br />GENERAL DESCRIPTION: (the number of miles and directiox� zo e nearest town and the approximate' elevation): <br />i s Z4d, _s oT-1 fia 6 49 5 /EAS' Dr—IH E LnPLNe- 2 <br />ar Nt Y4 Se 1/4 SzcTION a i A7N / P -Z <br />NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or as supplemental information to <br />this NOL GPS measurements will be acceptable for this purpose:_Ajj6L _)g , �4RQ (Q,,, '(tj, 77&ga 1' <br />NE 39.34SC.38 , -106 .i7 q 318 SE 38.34L MV, —1W.774_S19 °: <br />_S 38.341218 ((')L.-7�g158 <br />�ic��.77y5�9. <br />11. �LAND O RSHIP ❑ <br />ivate Public Domain (BL National Forest (USFS) <br />State State 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 (BLM) 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 minimize administrative <br />processing time and effort. <br />G. CLAIMANT: <br />^ <br />Name: (�RQk PALM <br />Address: N A LEMDN'raa_ LAAir <br />oa-LA W o o �Lo a_1 Lo (4 32'53 C1 <br />Telephone: Z�Z 3X <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 <br />