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2 (:Form 2- Public) <br />TO WI~'SHIP (write number and check direction} T,_,_„_ i`i'orth _ South_ ._ ___ <br />RANGE (write number and check direction} R East West <br />QUARTER SECTION (check one):_„_._.__ NE _NW S£ _ __. SW <br />QiIAR"i'EIL'QUAR'1'ER SECTION (check one):_ _ NE _________, NW __ SE S~V <br />GENERAL DESCRIPTION: {the number of miles and direction. to the nearest town and the approximate elevation): <br />NO"TE: Supply longitude and latitude or U'I:V1 coordinates if lands have not been surveyed or as supplemental information. to <br />this iv'OI. GPS measurements will. be acceptable for this purpose:_ <br />6. LAND OWNERSHIP <br />Private .~, Public Domain (BLM) ,,,__ National Forest (USFS) <br />State ~__._.._, State Sovereign Lands .„____•__Other (please describe}: <br />If prospecting is located on B:[,M or USFS land the remaining section must be completed, <br />otherwise go to section IT Maps & Drawings <br />7. PRUSPEC'TING ON BUREAU OF LAND NIANAGEMFNT (BLM) I.AuVD AND L' S FORES'C SFI2YICE (USFSI <br />LAND <br />The Division and the .I3LM/USFS have entered into cooperative. agreements that eliminate the need far a prospector to post a <br />financial warranty with each agency and allow them to coordinate the review of the NOI in order to minimize administrative <br />processing time and effort. <br />A. CLAIMANT: <br />Name: ~fA ~ G Lb. ~ ~~..~.f`.1;..__.• <br />Address• ..- <br />_[~_._ _ <br />--__.. <br />~~ ~~.3--4--------__ <br />Telephone: ~ ~-;~ _- S.z~ 1, ~ 0 2 Z <br />Fax Number: _.1.~1._..- .L4`~-~_..'•_.4.Z~~..........._..._._..........._. __..._.~ _.. _. <br />>3. SITE/CIfAI.M INFOR~yIA'CIUN; <br />List names, serial numbers and provide legal. description to nearest quarter-quarter section of all sites or claims {attach <br />additional page, if necessary}. <br />NAME S_I.:Rtt\I., NUMBER LF,GA.I =I)ESC;R.IP_I:IO?` <br />