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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: 31° 1! ' 15', X: <br /> Long: 108 I t�O"� Y: <br /> 6. LAND OWNERSHIP: <br /> Private i " I Public Domain (BLM) National Forest(USFS) <br /> State I 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 lIV! Jemset4 <br /> Address 4'SS U VIOW Mesa/ (vv <br /> City, State, Zip 6,r ai !J(NalOn f CO, a 1 <br /> Telephone (715 ) 750 6S63 <br /> Fax ` 1 <br /> Form 2-Public File Page 3 of 14 <br />