2019-09-18_PERMIT FILE - M2019050 ‎(6)‎

• Permit No: M2019050
• IBM Index Class Name: Permit File
• Doc Date: 9/18/2019
• Doc Name: Application
• From: Robert & Lauren Berry
• To: DRMS
• Email Name: ERR
• Email Name: MAC
• Media Type: D
• Archive: No

EXHIBIT G- Source of Legal Right to Enter
Rule 6.3.7(Starts on Page 143 of the Rules)
1) Name of owner to the surface of affected land:
Public Domain (BLM) F1 National Forest(USFS)
State _1 State Sovereign Lands
F Private(who):
Other(please describe):
2) Name of owner to the subsurface rights of affected land:
Public Domain (BLM) National Forest(USFS)
State State Sovereign Lands
Private(who):
F Other(please describe):
3) If mining is located on Bureau of Land Management Land (BLM) or U.S. Forest Service land (USFS) land
the remaining section must be completed:
i) Claimant: Robert Berry
ii) Serial Number: CMS 287911
iii) List Name: Robert Michael#1, Robert Berry, Lauren Berry
iv) Address: 3871 Black Feather Trail
v) Telephone: [phone]
vi) Fax Number:
4) If the mining operation is located on private, state, or state sovereign lands, please provide a description of
the basis for legal right of entry to the site and to conduct mining and reclamation for Owners of Record
described in Rule 1.6.2(1)(e)(i). This may be a copy of access lease, deed, abstract of title, or a current tax
receipt. A signed statement by the Landowner(s) and acknowledged by a Notary Public stating that the
Operator/Applicant has legal right to enter and is also acceptable.