NOTICE!! These documents have been scanned! Do not place un-scanned documents beneath this notice! Do not remove this notice from this file! GPO Jacket No. 560-102 Print Order 61540 Rise Business Services, LLC Job=AZ15 7/9/2019 11 1 1111 Ill 111111111 11'll ili il l'1111111 Ill I Box Number= AZ15152 l ili ll'111 11111111111 l illi lilli li lli 111 1 111 111111111111 Ill 11111111111111111 Ill I lil i 1111111111 Claim Begin-End: AMC449053-AMC449053 1 Initial Receipt lillilli lll'll'lll Illil illill 11'lll AZ15152-12 AMC448714-AMC449477
Transcript
NOTICE!!
These documents have been scanned!
Do not place un-scanned documents beneath this notice!
Do not remove this notice from this file!
GPO Jacket No. 560-102Print Order 61540
Rise Business Services, LLCJob=AZ15 7/9/2019
11 1 1111 Ill 111111111 11'll ili il l'1111111 Ill IBox Number= AZ15152
l ili ll'111 11111111111 l illi lilli li lli 111 1 111 111111111111 Ill 11111111111111111 Ill I lil i 1111111111Claim Begin-End: AMC449053-AMC449053
Ell Ell LOCATABLE MINERALS / MINING CLAIMS-I NEW,UNADJLID, ONE OR MORE AUTH NOS /1 2 111.001 -4»-1 F1CASES: AMC449053/$37.00 1--'U1 NEW MINING CLAIMS LOCATION FEE
NAME: FRYBARGER, DAVID2510 ANGLER DRLAKE HAVASU CITY AZ 86404-2134 US
REMARKS
This receipt was generated by the automated BLM Collections and Billing System and is a paper representation of a portionofthe official electronic record contained therein.
Do not place un-scanned documents beneath this notice!
Do not remove this notice from this file!
GPO jacket No. 560-102Print Order 61540
Rise Business Services, LLCjob=AZ15 7/9/2019
I Ill rIH Fli li~l i HI Ir I Hil lili i I Hil Nli liliBox Number= AZ15152
11111111 11111 11111111 lilli llill 111111 lil i lll I lIN 111 lili 111111 lili lln lill 111 11 111111 lil I lilli I I IllClaim Begin-End: AMC449053-AMC449053
4 Annual Filings
Illl'llilll'llilll I Ill'Illilillilli AZ15152-12 AMC448714-AMC449477
4 1 1 -75-9/ Form 3830-4 UN~-~ Lu, STATES FORM APPROVED
(January 2017) OMB NO.: 1004-0114DEPARTMENT OF THE INTERIORExpires: January 31 1070BUREAU OF LAND MANAGEMENT
AFFIDAVIT OF ANNUAL ASSESSMENT WORK
WHEN RECORDED, MAIL DOCUMENT TO: 9,4951NAME: DAVID FRYBARGER H 160*3ADDRESS: 2510 ANGLER DRIVE Li/0163
444093CITY, STATE, ZIP: LAKE HAVASU, AZ 86404
FOR COUNTY RECORDER'S USE
No. of Claims 7
x $10/claimTotal due BLM $ 70.00
TO ALL WHOM IT MAY CONCERN:
1. The undersigned certifies that at least $100 per claim was expended for development, labor andimprovements, or equivalent value added, as the annual assessment work for the assessment year endingSeptember 1, 2019 for the following contiguous unpatented mining claim(s), located in the County ofMOHAVE- in the State of ARIZONA
Tp Rg Sec Mer County Recordation Co. Recor ingBLM Serial No. Name of Claim Example: 133 SE 14 MDM Book and Page No. Date
L :TALAJ) /3,k -N- -O ·0 01(Continued on page 2) EFEEM.OR'Ir =AUG 2 9 2018 ~ ~
BY·.__IEh_M
2. Type of labor and improvements (specify what was done and give the total value for that tabor andimprovement to show at least $100 for each claim). Ifa geological, geochemical, or geophysical survey wasperformed, as per 30 U.S.C. 28-1, re ference the title of the report of survey, give cost and date of the surveyand report, and indicate it was filed with the County Recorder:
Value of Work Date Work WasDescription of Work Performed Performed Performed
Mineral sampling and identification 300 05/12/2018
3. Name and mailing address of each person who performed the labor and improvements:
Name (please print) Current Mailing Address (please print)Ed Huskinson/Geologist -4804_Steinke DE, Kingman, AZ 86409David Frybarger 2510 Angler Drive, Lake Havasu City, AZ 86404Stephanie Holmes 1745 Squall King Dr., Lake Havasu City, AZ 86404Laurie Bergeron 2731 War Eagle Dr., Lake Havasu City, AZ 86404
4. Name and mailing address of each person who holds and claims the subject mining claim(s) for the valuableminerals contained therein. Be sure to indicate if there is a change of address:
Name (please print) Current Mailing Address (please print)David Frybarger 2510 Angler Dr., Lake Havasu City, AZ 86404Roger Frybarger -25-16-Angler DE--Eake-Havasu-6@3286464Jack Hodges 3656 Winston Dr., Lake Havasu City, AZ 86406Stephanie Holmes 2745 Squall King Dr., Lake Havasu City, AZ 86404Laurie Bergeron 2731 War Eagle Dr., Lake Havasu City, AZ 86406
-nj I./ f-13-m = 4
rt' ...= 7730 H.c-
5. The undersigned testifies that on the date of -281198!121__, 1*18, all moiqulnentsrequired by law were erected upon the subject claim(s), and all notices required by *v we70 pos@d on thesubject claim(s) or copies thereof were in place, and at said date, each corner monument bR-p or@ontained
(Continued on page 3) ( Form 38304. page 2)
t
markings sufficient to appropriately designate the corner of the claim to which it pertains and the name of theclaim(s).
I hereby certify under penalty of pegury under the laws of the State of ARIZONA that theforeg~g statements are true and correct:
Date:.~4~1_-Gv--4-Q-/ 9(Signature of erso resp si e for above statement)
Title 18 U.S.C. 1001 and 43 U.S.C. 1212 make it a crime for any person knowingly and willfully to make to any department oragency ofthe United States any false, fictitious or fraudulent statements or representations as to any matter within its jurisdiction.
Notag BlockSUBSCRIB D D SWOR Obef e, is_ /6__day of__~46~-_____ 20 ~ ~~r
By: 0(Ejignature of Affiant)
Title:BRENT DEWITT
Notary Public - ArizonaMy Commission Expires: Une /3 20 Mohave County
~2*~./ My Comm Expires Jun 10,2019
INSTRUCTIONS
1. This is an optional form that may be used to satisfy the requirements for the Bureau ofLand Management (BLM)under the provisions of43 U.S.C. §1744 and 30 U.S.C. §28-28d and the regulations thereunder (43 CFR part3835). Since local and State laws may vary, you should contact your local and State agencies where the claimsare located to ensure all applicable laws and requirements are satisfied.
2. The claimant(s) must fill in the date in paragraph 1 for the applicable assessment year al#0 theAgunty*nci statewhere the claims are located. ZC CO ,--
3. All claim names, BLM serial numbers, legal descriptions, and original county recording,nfoltion.Miust belisted for the claims pertaining to this assessment notice. Z Si FOX/
4. The claimant(s) must complete paragraph 2 listing alliabor or improvements which w*Sperfooned'ch{* didbenefit the subject mining claims. The value and date of the labor or improvements *st alsNe list@DThe totalamount of labor or improvements can be listed, but the total expenditure must equal adast SUO fof·*h claim.
5. The names and current mailing addresses of the person(s) performing the labor shall @isted m paF**h 3.6. The name and current mailing address of each owner (claimant) of the claims shall b*sted #Pparagraph 4. The
mailing address shall be the owner's address and not the address of an agent or anyo#reprejtin~he claimant.Be sure to note ifthere has been a change of address.
7. Paragraph 5 shall be completed to show the date it was verified that all monuments required by law were properlyerected, all notices were posted, and that corners were appropriately designated for all claims listed.
8. An exact legible reproduction or duplicate (other than microfilm or other electronic media) of this affidavit oranother type of affidavit of assessment work that you file or will file in the county where each claim is located,must be filed with the BLM on or before December 30 of the calendar year in which the assessment year ends.For mill or tunnel sites, a separate notice of intent to hold must be filed with the BLM on or before December 30.Requirements forfiling anotice of intent to hold can be found at 43 CFR 3835.33.
9. A processing fee of $10 for each claim listed must be remitted to the BLM along with this or any other affidavitof assessment work.
(Continued on page 4) ( Form 3830-4, page 3)
COf-
161 AUG
-r
m r-1NOTICE OF INTENTION TO HOLD MINING CLAIMS/SITES ZWhen Recorded Return Document to:BLM r.3A v/bDate0 32> Stamp -VA d 1 640
0 e 40 Check here if this is a change of address.Telephone: ..EN!1 _230 -9 0 30E- mail Address : 6 01 v / A prly dA R 6/ER-G 6/,A CL . com
1 (We) intend to hold the claims(s) and/or site(s) listed below for the calendar year 20 1 5, and I (We) have filed or willfile a Notice of Intent to Hold in the county where the claim (s) is located.Reason for filing a Notice of Intent to Hold instead of an assessment work filing (check one):%29 Maintenance fee was paid to maintain claim(s) during this assessment year.0 Mill or tunnel sites.0 Claim(s) was located during the current assessment year.O BLM has deferred assessment work (attach copy of decision granting deferment, or pending petition fordeferment including date petition was filed.)
AMC COUNTY RECORDERLine CLAIM/SITE NAME T\NP RNG SECNUMBER DATA (If available)No.
NOTICE OF INTENTION TO HOLD MINING CLAIMS/SITESpage 2
0BLM 171Date Z 51 -JMStamp
r.1 2 77" 0
!2 A.11>0
1. State of Arizona, County of Bl D WA v E
2.1(Name) 1'>RviD FAY/514/16023. Reside at (Address) 2 51 a A A~ 61 L /2 b A
City 1A H.4. 14Ave 51 0ry County MoHAVR State Al Zip 56 404 being duly sworn , depose andsay that I am a citizen of the United States, more than eighteen years of age, that all of the facts set forth in thisnotice, subject to the provisions and penalties of 18 U.S.C. 1001 pertaining to the filing of false, fictitious, or fraudulentstatements with the United States, are true and correct according to the best of my knowledge, information and belief.4. Owner' s name and address (If not shown in Items 1-3 above). b 4 v HZ> FR E R /1 A OER A MA
L AURI 6- R ,22 C. r. T AN 1 -7 7 1 0-) A R F A /. LE As. , AL,£ ItAVASU E IT'l A -1- 76 11 065. Dated: Signature:
No. of Claims: X$10Bureau of Land ManagementCheck No: Init.Arizona State Office
EYME.blm.govlaz Receipt No.:For BLM Use Only
Form: NICF110Revised July 2014
Page 2 0 f 2
This form is available from the Arizona Geological Survey and may be reproduced.
1 /:1 ---- 1i _ -
US '04 INU A
PRESS FIRMLY TO SEAL PRESS FIRMLY TO SEAL
9405 5118 9956 0152 9786 60
PRIORITY® FROM: I)4vib FR (f BARGER -0
011 *MAIL* 2516 8*GLE# DR.
kA R 6 H RVALU an , Al 3 64 ALI
[8] DATE OF DELIVERY SPECIFIED*
6~ USPS TRACKING™ INCLUDED*
4 ®AZZE ~:0~~ZZZme=271%nJ~u'mm=$*pre ses, loi :ou s! 8~15;eyjsod st 1~401;°77°'t
~ INSURANCE INCLUDED* TO:d51 PICKUP AVAILABLE U S . ~ EPA rer MeNT oF THE f *19*A)OR
E LAI
·ule
ae -
elo
Aoe
i ese
eld
'ais
eM
lalli
nstio>
;sod u
lo4
epelll
51
edol
eAU
D s
!41
* Domestic only Flu RE. Au OF LAdD MABAGEMEw'r *31
Ill 11111111111111111 lillill 11111111 EP14F July 2013 VISIT US AT USPS . COM ® UNITEDSTATESPS00001000014 OD: 12.5 x 9.5 ORDER FREE SUPPLIES ONLINE ~POSBLSERVICE®
&
Recejpt Page 1 of 1r'
United States Department of the InteriorBureau of Land Management Receipt
DIV OF LANDS, MINRLS & ENERGYONE N CENTRAL AVE
PHOENIX, AZ 85004 -4427 No: 4243688Phone: 602-417-9200
Transaction #: 4359134Date of Transaction: 08/24/2018
CUSTOMER:
E,«Iff-------------]DAVID FRYBARGER
LAKE HAVASU CITY,AZ 86404-2134 US
DESCRIPTION 1 REMARKS 11 IITOTALI1 H PRICE H ILOCATABLE MINERALS / MININGCLAIMS-NOT NEW-UNADJUD,ONE AUTH OL 2018/7
1 1.00 NO. ONLY / MINING CLAIM MONEY WAV NOI -n/a - 80.00RECEIVED 018/1CASES: AMC411759/$80.00
NAME: FRYBARGER, DAVID2510 ANGLER DRLAKE HAVASU CITY AZ 86404-2134 US
REMARKS
This receipt was generated by the automated BLM Collections and Billing System and is a paper representation of aportion of the official electronic record contained therein.
L This small miner waiveristiled for the,issessment year hezinning on September I. Aol Y, and ending on Septembel· 1, A «t_9_ .2. ] he undersigned,liclitil re!,itid p.irtie. 4,wn:il ten or l'ener mining elaims . mill. or tunnel sites located und maint.lined im Feileral lands iii the United States
iii'America im September I Aol Y3. lhe undersigitedlm'c per forined tlie ascessment u·ork rellilil':d by law for each mitili,g claim listed pricir {Ofililly this waiver alid underwtand thait l)>' filing this foriii.
the till( iersigned maisi file :111 allid,ivitc)# assessm:lit work with the Bureau of Land Management (13[.M) by the December.1(}th following the filing ofthis waiver.4. I he underbigned li,icle!:st,itid th.it il'the assessment work obligation has mit >·et com: due under 30 U. S.( '. 28 ( 12 r tliose claims in their fi rst as.sessment year 4,1 ily).
;1 1 1,1 tic: 411 int:flt to 1 1,1 Id reciting this condition must be recorded by the December 3(}t h fol Inwing the filing 4,1't Iii b n·itiver.5. Ih: iii kiersign:li unlierst,11!d that mill ami tutiti:l .sites tiiay alsi) be listed ()11 thiS Walier,uld lie waived fi'()111 pitymelit lit th: niaint:nance l'ee, iillil that a iiditic: of
intent to hold furthese sites ix required to he *Hed with the BLM by the Dee:mher .3(lth foliciwing the filing of this uitiver.6. i he undersigned understand alic! uckric,KI:dye tlicit pursuant to 43 U.S.C. 1212 and ]8 U.S.C. 1001. the filing or recoriling ofa l,ilse, fictitious, £11· f.litdill:1,1
(|(}cilin:lit with the Bl.M may result in n fine 01'lip to $25().C)(M), a prison term not to exceed five years, (71· both.7. 'I lie liiining claims, mil l l)[ ttlilizel hites fur which tlii, #vaiver 19 (,In payillent ol the maintemince k:. is 1-equghteli al e:
Data Entered: A ,~13 1 N (1*'V\ MTP Checked By: .__2__0~),I_/~tff>»GEO Checked By: --2-U.I.*K»,
1-EAD SERIAL NUMBER: AMC »(/ <19~0 thru AMC
NUMBER OF CLAIMS & TYPE: CHARGES:
LODE Processing Fee @ $20 = __i____-301
PLACER Location Fee @ $37 = $ dY-7.-
ASSOCIATION PLACER Maintenance Fee @ $155 = _1____,lfl_-MILL SITE Add'I Maint Fee for Assoc Placer = $-
TUNNELSITE SUBTOTAL $- --I
TOTAL ACREAGE : Per Claim Other Fees $( placer Only) Other Fees __$
NUMBER OF LOCATORS: TOTAL $ .4-1 67-\
DOCUMENTS RECEIVED VIA: Over-the-Counter [ ] Mail L>41 TIMELY FILED: Yes (>41 No [ 1
LEGAL DESCRIPTION : T fF\1 R /(0 00 sEc /hT R SEC----i.i- M-i-i.i-*-I--.i-I- -
T R SECT R SECT R SEC
BLM [ ] FOREST SERVICE [ ] SUBJ TO PL 359: Yes [ 1 No { 1WILDERNESS AREA [ ]
SPLIT ESTATE: N/A [ ] SX [ ] PX [ ] OTHER [ 1 --SRHA [ ] Was proper Notjce filed if located on SHRA Land? Yes [ ] No [ ]
MC 9053
RECONVEYED MINERALS ON BLM LAND REQUIRE OPENING ORDER FROM 1944 TO 1993:Open to Entry On N/A [ ]
COMMENTS/STATUS: VOID [ ] PARTIALLY VOID [ ] PVT MINERALS [ ] WITH DRAWN LAN DS [ ]
OTHER [ ]
[ ] Claimant acknowledges that portions of the following clairn(s) site(s) may be void or voidable.
Printed Name of Claimant Signature of Claimant
******************** FINAL ADJUDICATION ********************DATE INITIALS
GJHER RG<c>Kies PACASE 8 Flfilxt-' 7-0 2
ID 4 v is faYBAR Gr R
LA ke M Avqsu Ed,-9 , Al S 6 1 6 9
LOCATION NOTICE FOR LODE MINING CLAIM
0 Amendment BLM Serial # C .1BLM r.,
NOTICE IS HEREBY GIVEN that the DateStamp
111'TLE /4944 4 6 lode mining claim has been located 3 ·
1918 FEB -1 P 2: 0
by -1:>A 1/1 6 FAYBAA GER whose current mailing
- address is 251 0 /3/u C. LEA bA i VE
LA Km HAVAsu Orr Al %6404The general course of this claim is S Lu TO /V E and it is situated in /00 U A vE
County, Arizona. This claim is /500 feet in length and 660 feet in width.
1 0 Total Claim Acreage. This claim runs from the location monument on which this location notice
is posted on the centerline of the claim approximately 750 feet in a S W direction to the SO U TH
end line and 750 feet in a NE direction to the /U ORTU end line. This claim is marked by six
monuments, one at each corner and one at the center of each end line of the claim.3>
The location monument on which this notice is posted is situated within Section / 0 , Township /7 ZIZZ
M , Range / 6 W , Gila Salt River Base and Meridian, Arizona and this claim encompasses portions
of the following quarter section (s), section (s ), Township(s ) and Range(s) ~/V 63 A N .& SE OJA ATE <
C 4 4 9 0 50 6 Wt»1 1 /6 LAJ
Gila Salt River Base and Meridian, Arizona. L,J
The locality of this claim with reference to some natural object or permanent monument and additional information
(if any) concerning itslocality areasfollows: 106.Arth> 13*10~20$7* *r~LY /.i M,-LAI. ...0 - - L I p
b i ry-A 1 67- The above information is shown on the attached map.
DATED AND POSTED on the ground this ~1 f N day of A MuAAY , 20 / Z.
*~LOCATOR(s) O AGENT
Print Name(s) S Y F O 1
Signature(s)Form MCF100
Revised July 2014This form is available from the Arizona Geological Survey and may be reproduced.
t *i--
1018 FEB -1 P=\ Rr--r.
...
1 m
ile
. 1
2 C AlMINING CLAIM MAP
Lode 0# Placer ( )4- 1 mile -I Millsite ( )
'0
A bli <ov ERY Mocvv *,ENTA. 6 1 /4, b r0 7 6.RABAS ARE LoCAFF>6-1\11 /1~ ..~19 THE N C 'QUARre.A or5 66rror. i O
TH E S E 60 N MER is1 0 GRfs> t w rw £ 5 EQuAA1154 0/5 5,5*TioN /0
SL7-His 61.Alm i.f AbJAcewrTe LITTAM /n ; DA #3
Scale. 1" = 2000 feet ~1. The above map depicts the _11 rf-1.5 /)11_(4_*Lfi mining claim, which is located in Section (s)
I 0 , Township /7 N , Range / 6 W , Gila and Salt River Base and Meridian,m 014Ave County , Arizona . Total claim acreage is 0
,2. The type of corner and location monuments used are as follows: _1__LL-_LEL.Z..22-&___iaL*LLEE_fV 6 4
A C44q053
3. The bearings and distances in degrees and feet between claim corners and to a public land survey monumentare as depicted on the map.
4. If the claim is a placer or millsite claim with exterior limits conforming to legal subdivisions of the public survey,provide a legal description of the claim-
Form MCF10OaRevised July 2014
This form is available from the Arizona Geology Survey and may be reproduced.
RUN TIME: 11:35 AM RUN DATE: 02/13/2018DEPARTMENT OF INTERIOR Page 1 of 1
T 16%N SCALE in choins Thts plot: Uie Ek,rec~'. Recerd I TRIa~ .d 5~1~~~~d be used'UR.IMG ...m'..
10 SO . 20 30 60 * cs o gr* *lay of Ih~ town#ney dc. Rec- _2.28.2017ACA0-=-El~--Ylords h,r=do W .flect UUe .Ing,5 .hich moy hM 'emeffected by ~ateral movernents It .vcrs or other .*cs of wcter..Yer I le codostrl -. f~ ..c~ ..Illform~'&.
-
.:,2.-#
1
e aq Aeut asns!W slueuld!45 ®
~~
10[1
~ S
UID
Uas U
! asn Joi A
lalo
s pepiAoJd s! pue ®a 0 ~
adoid
ell; 51 6u!62)10ed S
!41
PRIORITY® FROM: Dlv,·b FRYBARGe 5-1
·paA
JOS
ej s~
46!J li
'ELOZ A
lnr 'e~!MaS
leisod S n @:it,ldE
I elesm
JOJ Jou st BuIS
e>ped s!41 1 p
ap
eJ
Jo uo
!le'0
!A
*MAIL * -3 =2 5/0 RAIGLER Da.
·Ule
69 -
alo
AD
el e
seel
d W
seM
Jel
unS
UO
J-1s
od w
o
apeul
adol
eAua
514
1 ~ ~A <K Hauafu City , Al <264 uy 8 ~ 1- 1 z
-1 rD[iii] DATE OF DELIVERY SPECIFIED* - _.1 4 '
3> 1<11-1-1060 USPS TRACKINGTM INCLUDED* ri , rl ,
@ N 7~ INSURANCE INCLUDED* TO: 2 1
~~ PICKUP AVAILABLE U . 5 . TI> E PA ATA Eff 6 8 1-*#E j Nfelork* Domestic only 8 oRMA u OF L*MO /7)ABA 66/b EFT 1
) /Vof<TH CE FrABL Avf. 5-vir£ 300
WHEN USED INTERNATIONALLY,A CUSTOMS DECLARATION ~ 13 HOEM />C /) 5.- 950 0 L-/ - 2-1 927 1(3
SLABEL MAY BE REQUIRED.
*_-_B *
Expected Delivery Day: 02/08/2018
USPS TRACKING NUMBER
m VISIT US AT USPS . COM ® ~3~11NlIEQXT~[ElORDER FREE SUPPLIES ONLINE .74 POSTAL SERVICE.
