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1425 1/2 13 Rd 1425 1/2 13 Rd <br /> Street Street <br /> P.O. Box 245 P.O.Box 245 <br /> P.O. Box P.O. Box <br /> Loma, Co, 81524 Loma, Co, 81524 <br /> City, State, Zip City, State, Zip <br /> (970 ) 858-3657 (970 ) 858-3657 <br /> Telephone Telephone <br /> (970 858-3657 (970 858-3657 <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 /> 5. <br /> LOCATION INFORMATION: <br /> County: A � <br /> Principal Meridian (check one): <br /> In6ch (Colorado) � 10th rl Ute <br /> (New Mexico) <br /> Section (write number) TOWNSHIP N S <br /> RANGE © E F W Fa <br /> QUARTER SECTION (check one): <br /> NE NW SE SW �yt 3a <br /> QUARTER/QUARTER SECTION (check one): <br /> NE ❑ NW SE SW <br /> GENERAL DESCRIPTION: (the number of miles and direction to the nearest town and the <br /> approximate elevation): <br /> 71 C/Y CLhQ,;k— 7L Is— <br /> Form 2 Public File Mu�Ye 2 of hl <br />