Laserfiche WebLink
2 {Form 2- Public) <br />TOWNSHIP (write number and check direction} T_J~ North Sauth~_ <br />RANGE (write number and check direction) R~East VlWest ..._~__._.__ <br />QUARTER SECTION (check one): NE NW SE _.,...~SW <br />QUARTERlQUARTERSEOTION (check one}: _I`'E lVW _~~SE SW <br />GENERAL DESCRIPTION: (the number of miles and direction to the neare/s't_town and thGe~ approximate elevation): <br />NAME SERIAL_NUM.BER LEGAL llESCRII'TIOi'ti <br />L~~t~ ~Z. CMS.. Z 6q 3 Z l J E ~ aac ~~ 5 ~/ y5~ d -~ ~S~c , l 7 , 1' I Z <br />NOTE: Supply longitude and latitude or UTlv4 coordinates if lands have not been surveyed or as supplemental information to <br />this NOI. GPS measurements wilt be acceptable for this purpose:_ ___~ _ _„_.,_~_ <br /> <br />6. LAND OWNERSHIP <br />Private Public Domain {BLM) National Forest (USES) _~__,._ <br />State _~ State Sovereign Lands _ Other {please describe): ____ <br />If prospectintg is located on BLM or USES land the remaining section must be completed, <br />otherwise go to section II Maps & Drawings <br />'1. PROSPECTING ON BUREAU OF LAND iy1ANAGEMIsNT (BLM) LAND AND U.S. FOREST SERVICE tUSFS1 <br />LAND <br />The Division and the BLM/USFS have entered into eooperattve agreements that eliminate the need for 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: /ACC /~C~~`Ei~ ~____ <br />Address: `~~___~pX __-~-~-___ <br />Telephone: _._._ ~ ~U ;. ,~l70 - ~c~ <br />Fax Number: ~A <br />E. SI'Z'E/CLAIM INF(}R~'~IA'CION: <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 />- ~~ ~c Lo'ur,~ fr •~~~k S'r~~e v~ of ~"~-~~. <br />