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1 R- 4© `R d ►� v� e� <br /> Street Street <br /> P.O. Box P.O. Box <br /> e,c.dv I�� �o SoLk0 I L avill ) Ca ga <br /> City, State, Zip City, State, Zip <br /> (7 / c ) �� -� q D (1jc ) 293 -41c <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 /> 5. <br /> LOCATION INFORMATION: <br /> County: <br /> Principal Meridian (check one): <br /> NI 6th (Colorado) 10th Ute <br /> (New Mexico) <br /> Section (write number) 22 TOWNSHIP 12 N S <br /> RANGE 7, E ❑ W <br /> QUARTER SECTION (check one): <br /> NE NW SE SW EX <br /> QUARTER/QUARTER SECTION (check one): <br /> NE NW IN SE SW <br /> GENERAL DESCRIPTION: (the number of miles and direction to the nearest town and the <br /> approximate elevation): <br /> IN\ lis sow-l--In o .StAetctoo/+5A-6 a o late,„) , -� e`I' <br /> Form 2—Public File Page 2 of 14 <br />