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~~ - <br />MINE REPORT 3~~ <br />?a'r't-0 <br />J <br />~!'` <br />~' <br />~L.GJ~ <br />J <br />Note-Please fill oat this report carefnllY, write plain]y and answer a12 gneationa folly. Be sore to <br />dote the report and sign it~. FI-II)'o'nt both aides of the sheet. ~ ,,~} <br />_-_"____----t---~-Colorado ~~~~~ ~ ~ ~ -ti.,,_ <br />----------------- -----~ 19--- <br />BUREAU OF MINES, STATE OF COLORADO. <br />T. R. $enahen, Commissioner of i+fines, <br />Denver, Colorado. <br />Sir: Ia accordance with Section 4299, Revised Statntea, Colorado, 1908, I eabmit report as follows: <br />Name of Company-The______~Q~tiv ~'~-~/ <br />--------~v e ------------- <br />----- <br />Incorporated in the Stato of_____________________ <br />------------------ <br />--------------- <br />Principnl otl3ce _____________ <br />---------------------- <br />----- <br />It.COn Capital stock ____________ _______ Shares, at $____________ Per share. <br />-------- <br />E11 out 1~ <br />i~~ie°Onu1°°nk~ Name P. 0. Addressee <br />President ------------------------------ <br />--------- ------------------ <br />----------- <br />Secretary _______ <br />u , et., <br />or D.tmawp <br />EII ovt lhb <br />tD,oe~ othenrlN <br />Ierve It bLvk <br />--------------------------- <br />1lfanager --------------------------------------- <br />----------------------------- <br />~Title of Partnarship________________________________________ <br />---------------------- <br />Partners' Names P. O. Address <br />-------------------- ----------------------------- <br />-------------------- <br />Treasurer ------------------------- <br />___. <br />aVlIInagCr____________________________________ <br />_________________________________ <br />Names oP Owners P. O. Addresses <br />It ovllhet <br />romp,nr vor <br />Nnnenhlp, <br />CII out titL <br />,p,n <br />~, <br />__________________________________ <br />`dfanageC _____ <br />Stutc names of claims: <br />Patented <br />________________________ t <br />___ \ <br />~,~,t,~~ _ Unpatenteti ~j <br />--- <br />'------------ ~T/~~ ~-,-~~-, -Q--~--~-~-,-t-~ ~1----~- ---- <br />__ ____ _ <br />------------------------------- _ <br />-- - - --- N-`?'rc~~~rJ~--------------~F-- <br />___.___f <br />________________________________ _ ~~~yyJ~~ <br />Total acreage patented--- ---------------acres; nnpatented P?c~L-Y__~__ -- Y <br />------- 2 o-D ---acres. <br />~----- <br />Do yon own or lease these claimal____ <br />f you ]ease them give name of company or person from whom lenaed___________ <br />- --------------------------------------------------- <br />(Over) <br /> <br />