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t <br />1 <br />' 3. Addrass and Phune u.~oer of <br />LOGaI Jfflce5 <br />' w. ,lddress and Phone Numb r of <br />' ;,aneral Offices <br />5. lame and Phone Numoer of P rson <br />Starf Alemoers Snouio iantac <br /> <br />-z- <br />P.O. Box 106 <br />Montrose, C, lorado <br />249-7864 <br />81402-1063 <br />2925 LB Freeway. 11279 <br />Dallas Texas X5234 (214) 241-7811 <br />Gilt~rt F. Rindafil, Rindahl 8 Associates ~•~ <br />eau of Land h1;3nagement <br />' ti. 1h+ner(s) of ~tecord of Affecte Lanu <br />(surface area) (If .no re than ,list below) <br />' 7. Owner(s) of Substance to oe :4ina / <br />(If yore than 2, list below) <br />' d. Source of Legal ~2ignt-To-inter <br />(Indicate what type of proof is <br />' included in EXHIBIT ,J - lease, <br />aced, notarizes letter, etc.) <br />9. Ty?e of ~•iine and Substance to oe ' fined <br />(Spacify unaergrouna, open pit, <br />quarry, etc. & suostanca(s) to <br />' ue rimed) <br />lu. ue~ieral Location and tlevat~ n <br />(Miles & direction from ne est <br />tuwn & aaproximate site el vation) <br />' .11. Jounty <br />' 12. Acreage of ,affected ands <br />(Total surface acre a to be <br />included in permit) <br />1 <br />13. application Fee Sae applicaole <br />' Mule to detarni a amount) <br />5125.00 <br /> <br />See patent claim holders <br />an last page of this report.. <br />i`otarized Statement <br />Placer mining <br />noble Minerals <br />miles East of Olathe <br />evation 5800 feet <br />se <br />9.9 aches <br />