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the Icasing com• lddress --------------- --------------- '--~°-u'-~- - -- x__ __hour shift. n___ _hour shift. ~r_ _ _ _hour shift. ~r____hourshitt. Ir____hour shift. Ir_ ___hour shift. Ir____hour shift. Ir___ _hour shift. rr____hourahift. rr____hour shift. Ir_ _ _ _hour ahi f t. ;_____~~ ~.~ 1- ---- ----- -~~dl ______________ j ~.~ v -t. 1_ ti J j ~~ I MINE REPORT ~ ''.''" Note-Please fill out this report carefully, write plainly and answer all questions folly, Be sure to date the report and sign it. Fill out both aides of the sheet. ----- --------------------------~ Colorado /'`~' ~ _v/ ~19~_`# BUREAU OF DANES, STATE OF COLORADO. T. R. FIennhen, Commissioner of Dines, Denver, Colorndo. Sir: In aceordnnce with Section 4299, RsvisedStatutes, C~olor,~ndo/, 1908, I eltbmit report ns follows: Name of Company-The__~5~__Wi!'r-!~_ _ _ ~ \_ _ ~_ ---- Incorporated in the State of________________ _______ _ ____ ________________ If . Comp.nr, all out t la apaee• atherwlq (rare It blank Principal office __________________________ __ ~"~!~-! Capital atoclc __~ __Q_ Q ~.r _a°-6__- __ Sllnres, nt Nome President ___ ~ _!~ t__ ___________ Secretary --------- ~ - -- - - ----- - -- Trensurer ----lL---------------d--~ ------------ Diaunger r ------ ~---------------- u------------- -T__!_____-._ per shore. P 0. Ad~resses OU.Y.,(~a~~t----- ~~ --- cc v ----------------------------- ~t------------- ~----- of Partnership-------------------------------------------------------------- Partnm•s' Nnmcs P. O. Address If . arm or partnrn6lp, all out thla apses; atherwbe learn It 61mk Dlnnngcr------------------------------------ Nnmea of Owners It nrllher ~mpanr nor po rtnenhlpp, Il it nut thla npatt _!-~C.' ____________________________________________ P. O. Addresses __________ ---------- ntnnager----- ---------- ------------ --'---- -------------------- - ---------- State nnmcn of elnima: ---------- Pntented Unpntented rorkmen in the ~ / .~ - ----- -- ------------------------ -------------- -- ----- rf r r A -------------- r t r t it --------------------------------------- - ---- -- ------------------ ------------------------- ----- ------------------------°----°-------- Totnl ncrengc pntented______~ ~ ___-- G~-- -- -------arrrs ------------------------------------------- ; unpntented______ ~_,~ ~_____-. .. _-acres. -- Com ~ ` ° C Do you own or Jenne these clnimet____ __-- ---------------°------"'--" ~'~ -'~'- - ~ ------ --- y glue namo of compnn or If ou lenee them Y person from whom Jenne ________________________________ ------------------------- (Over)