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Street Street <br /> P.O. Box P.O. Box <br /> City,State,Zip City, State,Zip <br /> l <br /> Telephone Telephone <br /> C <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 /> Principal Meridian (check one): <br /> In61h (Colorado) El10th © Ute <br /> (New Mexico) <br /> Section (write number) � TOWNSHIP � N � S <br /> RANGE [--] E a W a <br /> QUARTER SECTION (check one): <br /> NE NW SE SW <br /> QUARTER/QUARTER SECTION (check one): <br /> NE ❑ NWFJ SE SW ❑ <br /> GENERAL DESCRIPTION: (the number of miles and direction to the nearest town and the <br /> approximate elevation): <br /> Form 2—Public File Page 2 of 14 <br />