Form 3830-3 - Notice Of Intent To Locate A Lode Or Placer Mining Claim(S) And/or A Tunnel Site(S)

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UNITED STATES
Form 3830-3
(January 2017)
DEPARTMENT OF THE INTERIOR
FORM APPROVED
BUREAU OF LAND MANAGEMENT
OMB NO. 1004-0114
Expires: January 31, 2020
NOTICE OF INTENT TO LOCATE A LODE OR PLACER MINING CLAIM(S)
AND/OR A TUNNEL SITE(S)
Homestead Patent Number
ON LANDS PATENTED UNDER THE STOCK RAISING HOMESTEAD ACT OF 1916,
AS AMENDED BY THE ACT OF APRIL 16, 1993
TO ALL WHOM IT MAY CONCERN:
This notice is filed under Public Law No. 103-23 of April 16, 1993 (107 Stat. 60), entitled “An Act to amend the Stock Raising Homestead
Act to resolve certain problems regarding subsurface estates, and for other purposes.” The undersigned place(s) all interested parties on
notice that, within 90 days of filing this notice with the Bureau of Land Management (BLM) and after 30 days from the date of receipt of a
copy of this notice by the surface owner(s) of a record, the undersigned intend(s) to enter the lands described below to explore for a
valuable mineral deposit(s) and to locate a mining claim(s), and/or tunnel site(s), as provided under the mining laws of the United States
(30 U.S.C. 22, et seq.). The area covered by this notice and all other notices filed by the undersigned and any affiliate(s) of the
undersigned, and which continue to be in effect on the date of this filing does not exceed 6,400 acres of such land in any one State and
1,280 acres of such land for a single entity. This notice, for a single State and surface of ownership, covers the following lands:
1/4
SECTION
TOWNSHIP
RANGE
MERIDIAN
in ______________________________________________ County, State of ______________________________________ .
Total acres under this notice ___________________________________ .
Name(s), telephone number(s), and mailing address(es) of affected surface owner(s):
Name(s), telephone number(s), and mailing address(es) of person(s) filing this notice:
____________________________________________________
______________________________________________________
____________________________________________________
______________________________________________________
____________________________________________________
______________________________________________________
Brief description of the proposed casual use exploration activities (i.e., activities that cause no more than a minimal disturbance to the
surface resources and do not involve the use of mechanized earth-moving equipment, explosives, the construction of access roads, drill
pads, or the use of toxic or hazardous materials):
Date(s) on which such activities will take place: ________________________________________________________________________
(Continued on page 2)

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