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2 (Form 2- Public) <br />TOWNSHIP (write number and check direction) T North South <br />RANGE (write number and check direr) R East Nest <br />QUARTER SECTION (check otter NE NW SE SW <br />QUARTER/QUARTER SECTION (check one): NE NW SE SW <br />GENERAL DESCRIPTION: (the number of miles and direction to the neatest town and the approximate elevation): <br />6.5 miles southwest of Ouray, Colorado 11,700, <br />NOTE. Supply longitude and latitude or UTM coordinates if lands have not been surveyed or as supplemental information to <br />this NOL GPS mcasuremcros will be acceptable for this purpose: <br />Longitude 107042, 30" <br />Latitude 37" 56' 30" <br />6 LAND OWNERSM <br />Private Public Domain (BLM) National Forest (USFS) X_ <br />State State Sovereign Lards Other (plow describe): <br />If prospecting is located on BLM or USFS land the remaining section must be completed, <br />otherwise go to section H Maps & Drawings <br />7. PROSPECI7NG ON BLWAU OF LAND MANAGEMENT M- M) LAND AND US. FORM SERVICE WSFS) <br />LAND <br />The Division and the BLMIUSFS 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 is order to minimize administrative <br />processing time and effort. <br />A. CLAIMANT: <br />Name: Jack Clark Sr. <br />Address: P.O. Box767 or P.O.Box F <br />Silverton, Co 81433 Ouray, CO. 81427 <br />Telephone: 970-387-5243 970-325-0112 <br />Fax Number. <br />8. SITE/CI,AIM INFORMATION. <br />List names, serial numbers and provide. legal description to nea=t quarter-quarter section of all sites or claims (attach <br />additional page, if necessary). <br />NAME SERIAL NlJhMER LEGAL DESCRIPTION <br />See Attached