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??9 <br />C?` <br />ar9° Rea sa e y <br />Ous?or o9 and <br />W*jW <br />JUL 2 6-Z010 <br />Din ®t d 1i, <br />' safety <br />IfiniNag <br />V/ r-" to -G(? <br />Form 2 (Public .File) <br />NOTICE OF INTENT TO CONDUCT PROSPECTING OPERATIONS <br />FOR HARD ROCK/METAL 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 />NOI.# P- - (Provide for Modifications to an existing N101) <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described below. <br />1. GENERAL INFORMATION <br />1. DATE NOI RECEIVED BY-.THE DIVISION: office use onl <br />2. PROJECT NAME:^°? <br />3. PROSPECTOR: PERSON MLRB SHOULD CONTACT: <br />Name' Name: <br />Title: 1r, F r - Title: ?-! '..:M fir? , r? S <br />Company Name: •?c ,s#. c 114 F'') r` Company Name: ? kxt - s <br />Street. n / ?l? fir / Street:,, <br />P.O. Box: P.O. Box: ?!•i <br />741 <br />City: <br />7- A <br />Clty.,, l, v <br />. <br />State: --._.....F::::...__..._... _ __...._._.... -..__... -- ---- <br />r <br />State: r' <br />Zip Code: W ? Zip Cade: o f ?% <br />Telephone Number: 21 <br />Telephone i`412mber: s?'l ?• '? `"'` ? -- :m <br />Fax Ntuxrber: C? - Fax Number: <br />4. APPLICATION FEE: $86. (NOIs require a $86 fee which must accompany this notice or it cannot be processed by the <br />Division), <br />5. LOCATION INFO11MATION: <br />County:.' '._U.=? <br />PRINC H"AL MEI,',.1DAN (check one) <br />S3 CTION (write nutriber): <br />_ -61" (Colorado) .--- O'?' (New Mexicc)) <br />S <br />(l." te)