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Lat: X: <br /> Long: Y: <br /> 6. LAND OWNERSHIP: <br /> Private fK�01 Public Domain (BLM) ❑ 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 <br /> completed,otherwise go to section II Maps&Drawings <br /> 7. PROSPECTING ON BUREAU OF LAND MANAGEMENT (BLM) LAND AND U.S.FOREST <br /> SERVICE (USFS) LAND <br /> The Division and the BLM/USFS have entered into cooperative agreements that eliminate <br /> the need for a prospector to post a financial warranty with each agency and allow them <br /> to coordinate the review of the NOI in order to minimize administrative processing time <br /> and effort. <br /> A. CLAIMANT: <br /> Name H A lu,2.E S O S PiELMA 10 F.T At_ (5 EE A r fVS1 of i tI-N MJ7-5 <br /> Address 2�TD.�� SNex Ao km <br /> City, State, Zip rM ojj T s� ( 6 S Z'A , r O $ ( 14--+ <br /> Telephone i 711 J S$d "' d - la <br /> Fax <br /> Form 2—Public File Page 3 of 14 <br />