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NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or <br /> as supplemental information to this NOI. GPS measurements will be acceptable for this <br /> purpose: <br /> Lat: IP 15 X: <br /> Long: 108 5t Y: <br /> 6. LAND OWNERSHIP: <br /> Private (Vj Public Domain (BLM) National Forest(USFS) <br /> State tt '' �� State Sovereign Lands Other (please describe) <br /> If prospecting is located on BLM or USFS land the remaining section must be <br /> completed,otherwise go to section II Maps&Drawings <br /> 7. PROSPECTING ON BUREAU OF LAND MANAGEMENT (BLM) LAND AND U.S. FOREST <br /> SERVICE (USFS) LAND <br /> The Division and the BLM/USFS have entered into cooperative agreements that eliminate <br /> the need for a prospector to post a financial warranty with each agency and allow them <br /> to coordinate the review of the NOI in order to minimize administrative processing time <br /> and effort. <br /> A. CLAIMANT: <br /> Name Cir111 .,i1A4Sehl <br /> Address 45b UVk w (NS& (6- <br /> City,State,Zip (j wvi4 iWC/ii On C, ( gf D1 <br /> Telephone (7 15 ) 750 6S63 <br /> Fax r <br /> Form 2-Public File Page 3 of 14 <br />