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Street <br />• i I <br />City, State, Zip <br />303) 888-6825 <br />Telephone <br />1693 Oneida Street <br />Street <br />P.O. Box <br />Denver, CO 80220 <br />City, State, Zip <br />( 303 ) 888-6825 <br />Telephone <br />) <br />Fax Fax <br />4. APPLICATION FEE: $86. (NOIs require an $86 fee which must accompany this notice <br />or it cannot be processed by the Division). <br />S. <br />LOCATION INFORMATION: <br />County: Custer <br />Principal Meridian (check one): <br />® 61h (Colorado) ® loth <br />(New Mexico) <br />Section (write number) 17 TOWNSHIP <br />RANGE 72 E W [Ed <br />QUARTER SECTION (check one): <br />NE R NW [] SE ❑ SW ❑ <br />QUARTER/QUARTER SECTION (check one): <br />NE ® NW 0 SE F-� SW ❑ <br />® Ute <br />22 N� so <br />GENERAL DESCRIPTION: (the number of miles and direction to the nearest town and the <br />approximate elevation): <br />Form 2 - Public File Page 2 of 14 <br />