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MINE REPORT '""~ <br />Note-Please fill oat this report carefully, write plainly and answer all questions fully. Be sure to <br />date the report and sign it. Fill oat both sides of the sheet. <br />-~~4~~CcGtl----------+ Colorado,~~%O__U ____ lv---, 19! ~ <br />BUREAU OP b1INES, STATE OF COLORADO. <br />T. R. Iieanhen, Commissioner of Mines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I suhmit report na follows: <br />Name of Company-The---------------------------------~-------------------- <br />Incorpornted in tlfe State of____________________.._________________________________ <br />Principal otTice -------------------------- ----------• -------------------------.. <br />Cnpitnl stock _________________________-_ Slmres, at ~____________ per share. <br />If • CAmpa°7~ <br />e" °nt t 1. Name P. 0. Addresses <br />rpare• °lherwW <br />Irux ie blank <br />President -------------------------------- <br />------- ----------------------------- <br />Secretnry --------------------------------------- <br />----------------------------- <br />Treasurer -------------------------------------- <br />llanager --------------------------------------- <br />of Pnrtnerehip___ __ rG_4/__.C-/_~(,~~f~d/~-tt~lll_'~_~_t____ <br />Partners' 1`nme P. 0. Address <br />_________~_'= _~E!= LU~____ <br />~. f.:_:~2------- -- <br />11 . Erm <br />or partnenhlp~ <br />1111 out tnla <br />gate; othrrwbe <br />Imrr I! blank <br />If neither <br />nupan) nor <br />partnenhi <br />all out tub <br />.°see <br />____ _ _ ___________________ <br />____. __' _ ~j~~ __________ <br />1lfnnager _~~r~e-_ [Y_~y~-~;_:~~~fl?'~ --- <br />Names of Owners <br />P. 0. Addresses <br />I ____________________________________________ ____._______________._____________ <br />titnle names of claims: <br />Patented Unpntented <br />---------------------------------------------- ---------------------------------------------- <br />---------------------------------------------- ---------------------------------------------- <br />'fotal ncreasc patented____-` ~------~-j--- ----a^-res; unpatented--------------------- ---.acres. <br />Do you own or lease these claimet____oC~cr~~ ------------------ <br />lf you lease them give name of com any ar person Yrom whom~lleased _--___/~-_________-_. ___ J_--=-- <br />`cu-.u. - -1~°~ f <br />(Over) (////f <br />