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REVISION - 9/4/2009, 7:35:25 AM-JWD
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REVISION - 9/4/2009, 7:35:25 AM-JWD
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Last modified
6/15/2021 11:33:51 AM
Creation date
9/4/2009 7:48:25 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
P2008043
IBM Index Class Name
REVISION
Doc Date
9/2/2009
Doc Name
Modification Request- Form 2
From
Powertech (USA) Inc.
To
DRMS
Type & Sequence
MD3
Email Name
ACS
Media Type
D
Archive
No
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2 (Form 2- Public) <br />TOWNSHIP (write number and check direction) T 10 North South <br />RANGE (write number and check direction) R67 East West ? <br />QUARTER SECTION (check one):NE NW RNW SE SW <br />QUARTER/QUARTER SECTION (check one): NE SE _DSW <br />GENERAL DESCRIPTION: (the number of miles and direction to the nearest town and the approximate elevation): <br />About 7 miles southeast to the Town of Nunn, Colorado. Elevation is about 5,560 feet. <br />NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or as supplemental information to <br />this NO]. GPS measurements will be acceptable for this purpose: <br />See Attachment A. <br />6. LAND OWNERSHIP <br />Private Public Domain (B National Forest (USFS) <br />State State Sovereign Lands Other (please describe): <br />If prospecting is located on BLM or USFS land the remaining section must be completed, <br />otherwise go to section II Maps & Drawings <br />7. PROSPECTING ON BUREAU OF LAND MANAGEMENT (BLM) LAND AND U.S. FOREST SERVICE (USFS) <br />LAND <br />The Division and the BLM/USFS have entered into cooperative 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: N/A <br />Address: <br />Telephone: <br />Fax Number: <br />B. SITE/CLAIM INFORMATION: <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 SERIAL NUMBER LEGAL DESCRIPTION
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