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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherrnan�L,Room 215 <br /> Denver,Colorado 80203 COLOR-ADO <br /> Phone:(303)%63567 REC DIVISION O F <br /> FAX:(303�832-8106 M INN MA <br /> SAFETY <br /> Form 2(Public File) <br /> NOTICE OF INTENT TO CONDUCT PROSPECTING OPERATIONS <br /> FOR HARD ROCK/METAL MINES <br /> CHECK ONE: There is an NOI Number Already Assigned to this Operation <br /> P-` _ (Please reference the file number assigned to this operation) <br /> New NO <br /> Modification to an Existing NOI <br /> P- (Provide for Modifications to an existing NOI) <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,ALL information described below. <br /> I. GENERAL INFORMATION <br /> 1. DATE NOI RECEIVED BY THE DIVISION: (office use only) <br /> 2. PROJECT NAME: <br /> 3. PROSPECTOR: PERSON MLRB SHOULD CONTACT: <br /> Name: Name: 0, (-(A f <br /> Title:h(A Ike o aga i 1S e- Title-6 <br /> Company Name: Company Name: <br /> Street: 1�7 3 S_N.6, ( A U Street: e:2 3G k)"E' <br /> P.O.Box: .y P.O.Box: <br /> City:pL, a �siN ' City: g t <br /> State: 6o State: ©RJR G 0 <br /> Zip Code: q 7 jj D // Zip Code: CA_'iQ:3 6 <br /> Telephone Numberj�b Telephone Number: <br /> Fax Number: Fax Number: <br /> 4. APPLICATION FEE: $86. (NOIs require a$86 fee which must accompany this notice or it cannot be processed by the <br /> Division). <br /> 5. LOCATION INFORMATION: <br /> Countk-hP e- <br /> PRINCIPAL MERIDAN(check one) 6`h(Colorado)010m(New Mexico) (ute) <br /> SECTION(write number): S _ <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand junction • Durango Active and Inactive Mines <br />