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2, Type of labor and improvements (specify what was done and give the total value for that labor and <br /> improvement to show at least$100 for each claim). If a geological,geochemical,or geophysical survey was <br /> performed,as per 30 U.S.C. 28-1,reference the title of the report of survey,give cost and date of the survey <br /> and report,and indicate it was filed with the County Recorder: <br /> Value of Work Date Work Was <br /> - Description of Work Pertormed Performed Performed <br /> CSN TWEE) T O PR PFCT o t t.1. iL C`1-14t it1114,- <br /> l,., <br /> 4jS r M 'i Too�.s , Ctr.ktti b I3aAri -k( FRO r\--0 TO.0b IC*. sm- S!/L - g"7 x/47 <br /> R t7 AD 4 <br /> ,OvE R OLO PRosPeldr AO LC—< 50.06 /et Furl- Fitt - a4pi ? I1 <br /> t t,.l's R& TRA'N 411D1120 t &t.etI - 'Ii` - g17 <br /> 3. Name and mailing address of each person who performed the labor and improvements: <br /> Name(please print) Current Mailing Address(please print) <br /> D --cs`l C• E 0 R.2t5r gas1 S. 1;t2 tnE3t) PK. LI1TLETOO CD MIA', <br /> �e P RE`? 5. FartREST" SOS'l s- V ry &IO PK• s h11TLE7-o+° , eo l?ota? <br /> 4. Name and mailing address of each person who-holds and claims the subject mining claim(s)for the valuable <br /> minerals contained therein. Be sure to indicate if there is a change of address: <br /> Name(please print) Current Mailing Address(please print) <br /> $t7st C. t=ot2Re l" lbS'i .S VERSE.3© PGA w L IT1LETOJJ3 CO 8'C)/ <br /> TJ FF RE9 5. FLR.Rt.Sr 9651 S. VE12016 Jt1 Pon4 kin ceTDrN,cd BOta7 <br /> • <br /> 5. The undersigned testifies that on the date of A[,l,G u S T 7 , 20 l 7, all monuments <br /> required by law were erected upon the subject claim(s),and all notices required by law were posted on the <br /> subject claim(s)or copies thereof were in place, and at said date, each corner monument bore or contained <br /> (Continued on page 3) (Form 3830-4.page 2) <br />