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275 Moonshine Circle 1805 Tunbridge Drive <br /> Street Street <br /> P.O.Box P.O.Box <br /> Reno NV 89523 Ricmond, VA 23238 <br /> City,State,Zip City,State,Zip <br /> ( 775)830-2744 ( 303)888-6825 <br /> Telephone Telephone <br /> ( <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: Custer <br /> Principal Meridian (check one): <br /> ( j 6th(Colorado) ® 10t Ute <br /> (New Mexico) ID <br /> Section(write number) TOWNSHIP Z(� �(Z N a S X <br /> RANGE 72 E ® W a <br /> QUARTER SECTION (check one): <br /> NE n NW n SE F] SW <br /> QUARTER/QUARTER SECTION(check one): See apentix 1 for detail <br /> NE n NW n SE (:] SW <br /> GENERAL DESCRIPTION: (the number of miles and direction to the nearest town and the <br /> approximate elevation): <br /> Form I—DBMS Use and Co»f& tial File Page 2 of 14 <br />