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, <br />1) <br />2) <br />2a6455 12/13/2017 02:57 PM B: 943 P: 311 LOC CT <br />Page 21 of 25 R $133.25 D $0.00 T $133.25 CIear Greek <br />11110 M 1ARHAWfF1�1� <br />EXHIBIT G - Source of Legal Right to Enter <br />Rule 6.3.7 (Starts on Page 143 of the Rules) <br />Name of owner to the surface of affected land: <br />Public Domain (BLM) <br />State <br />Private <br />Other (please describe): �W W <br />National Forest (USFS) <br />State Sovereign Lands <br />Name of owner to the subsurface rights of affected land: <br />Public Domain (BLM) National Forest (USFS) <br />State State Sovereign Lands <br />Private (who). <br />Other (please describe): <br />3) if mining is located on Bureau of Land Management Land (BLM) or U.S. Forest Service land (USFS) land <br />the remaining section must be cam a d: <br />i) Claimant: Irliv%itku, <br />ii) Serial Number: _ <br />iii) List Name: <br />iv) Address: 1215:41_ JCL.c Sot.' CZ MWj 2 <br />v) Telephone:_ 2 37 % I <br />vi) Fax Number: <br />rnona«"J- 6 F013z <br />4) If the mining operation is located on private, state, or state sovereign lands, please provide a description of <br />the basis for legal right of entry to the site and to conduct mining and reclamation for Owners of Record <br />described in Rule I.6.2(1)(e)(i). This may be a copy of access lease, deed, abstract of title, or a current tax <br />receipt. A signed statement by the Landowner(s) and acknowledged by a Notary Public stating that the <br />Operator/Applicant has legal right to enter and is also acceptable. <br />