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Y ' IVED <br />Arta 7, 7 2009 L-- <br />?, ano <br />GRANU . ,1D OFFICE <br />)F <br />RECLAMKlluiv MiNiNG & SAFETY <br />Form 2 (Public File) <br />NOTICE OF INTENT TO CONDUCT PROSPECTING OPERATIONS <br />FOR HARD ROCKIMETAL MINES <br />CHECK ONE: There is an NOI Number Already Assigned to this Operation <br />NOI # P- - (Please reference the file number assigned to this operation) <br />_ New NOI <br />Modification to an Existing NOI <br />NOW P_ - (Provide for Modifications to an existing NOI) <br /> <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALI. Information described below. <br />1. GENERAL INFORMATION <br />1. DATE NO] RECEIVED BY THE DIVISION: office use only <br />2. PROJECT NAME: G.e a S F' <br />3. PROSPECTOR: <br />Name: fYL G.)L ... W /t t <br />Title: 'F-7 c? E r o?7 <br />Company Name: ,z ' . Eli e Is o ca <br />Street: 75! a Z ?/ <br />P.O. Box: <br />City: <br />?t <br />State: <br />Zip Code: <br />.__-__?____`__-_ __--- <br />Telephone Number: g70 --916 - 7 S <br />Fax Number: 9'7c' 7_77_? <br />PERSON MLRB SHOULD CONTACT: <br />Name: <br />Title: <br />Company Name: .._....... ..--_-._.. <br />Street: <br />_._.---- <br />-.. _.- <br />P.O. Box: <br />City <br />State: <br />Zip Code: _ <br />Telephone :Number: <br />Fax Number <br />4, APPLICATION FEE: $86- (NOls require a $86 fee which must accompany this notice or it cannot be processed by the <br />Division). <br />5. LOCATION INFORMATION: <br />County: <br />PKINICI.PAL iEli_CDAN (check one) <br />SECTION (write number) <br />1t)`?` (New Mexico) <br />_._6'k' (Colorado) <br />S-.- -- - <br />(Ute)