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Street Street <br /> P.O. Box P.O. Box <br /> City,State, Zip City, State,Zip <br /> ( s73 ) -,� A - 1 ,5 ( ) <br /> Telephone C,�LC - S 7,3 -300-605&' Telephone <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: <br /> Princi al Meridian (check one): <br /> 6� (Colorado) loth Ute <br /> ® (New Mexico) <br /> Section (write number) TOWNSHIP ® N S gg <br /> RANGE E © W <br /> QUARTER SECTION (check one): <br /> NE Z NW [D SE SW <br /> QUARTER/QUARTER SECTION (check one): <br /> NE NW Z SE SW <br /> GENERAL DESCRIPTION: (the number of miles and direction to the nearest town and the <br /> approximate elevation): <br /> i s L c► Clc T O �T. <br /> Form 2—Public File Page 2 of 14 <br />