2016-08-19_PERMIT FILE - M2016011

• Permit No: M2016011
• IBM Index Class Name: Permit File
• Doc Date: 8/19/2016
• Doc Name: Need Permit
• From: DRMS
• To: Colorado Springs Mineralogical Society
• Email Name: WHE
• Email Name: TC1
• Media Type: D
• Archive: No

U
S NOTICE OF INTENT t.Sl=S SOUTH' PARK RANGER DISTRICT
1.4 it EMT qWF FOR MINING ACTIVITIES Date Received
d. _
Pursuant to 36 CFR 228
15 -day Response Date:
(U.c•e of this form it optional)
UWe, B �. _ Q
declare my/our intent to nduct .ming operatio n unpatented at ,Foe - - - 'vt + �a !G r
Park Ranger District of the Pike National st System Lands within the South
Forest. This mining activity will t e in the form(s) of
v ip7rrospectifrg, Exploration, Dev6&pm, nt .:r-Prodrtctionr
71
Name: 41111� tr
P:ione Number Ille
Mailing Address;
City:
Email:
State: a D
Zip Code; -e410/
Claim # I Claim Name
Surface disL rbance result'ng fro thi mi
Cuts, pits, trenches, drilling, shafts,
Reclamation Plan:
Township Range Quarter
(North or (East or Section(s) Section
South) west) (NE, SE,
SW.NW1
will be in]he fojrm of
cutting, ro /trail coiist'liction, tailings deposit, etc.
Estimated Acres of Disturbance. /
Work will be implemented by: &IRL4S 444f �
pecifv handwork, tv a of tool and or ma hineiy, et?
nhew-/
s) will be by. ic of /
Travel to the operation(s)
Specify rlpe of vehicle, foot travel, animal, etc
Owners of claims other than operator: `
List names and addresses of individuals, companies, etc.
Proposed start-up date and duration of mining activities (mm/dd/yy): / zoAr '71
2 CYG
SIGNATURE OF OPERATOR(S):
/O (tarn/dd/1!)
(nine/dd/>>1 J
••R Plan o O inions
f (form FS 2800-j), W;tt be required far all activities that involve naachoiety. ri-ce felting, nvad construction and other
activities that cuwyesignificant disturbance (36 CFR 228 4)
ATTACH MAP TO NOTICE: Map must show mining claim, both road and off-road access to work
site. Road access is shown in BLACK, off-road access is shown in BLUE, and proposed road and/or trail
construction is shown in RED,