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. ~., ~ ,_ • _ ,, ,1 ~_ <br />: lensing cam- 0 /V" <br />MINE REPORT ~ i" <br />rase ~ (~ Note-Please fill ont this report earefnlly, wrl and answer all questions folly. Be sure to <br />'~--!--~ i ~ date the report aad sign it. Fill out both aides of the sheet. <br />---------. _ _~~Gi?!L4FK_____~.,1~Colarndo <br />~_____, , _~~-L~m~r__ ~ __, 19L.i <br />_______ BUREAU OF bIINES, STATE OF COLORADO. <br />T. R. Iienahen, Commiesioncr of \finea, <br />_"-""'---- Denver, Colorado. <br />____________ Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />If . Comvveor, <br />All out thle <br />lure: eNerwlw <br />Isere it blank <br />Ir . arm <br />or partnrnhip, <br />All ou[ th4 <br />tpere• atherwlee <br />learr Il bunk <br />Ir neither <br />rumpenf nor <br />partnrnhlpp, <br />All nut lhle <br />•pece <br />President ______________ <br />-------------------- <br />-- ------------------- <br />---------- <br />Secretnry ______ <br />--------------------- <br />--------------------- <br />-------- <br />Trenaurer -------------------------------------- <br />----------------------------- <br />iliannger --------------------------------------- <br />~Nnme of Company-The--------------------------------------------- <br />------------- <br />orpornted-in ttte Stnto of________________ <br />-------------------------- <br />------------ <br />Principnl once _____________ <br />Cnpital stock _______________________ ___ Shnree, nt ~____________ per share. <br />Nome P. 0. Addresses <br />"Title of Partnership <br />-------------------- <br />~~artners' Names P. 0. Address <br />--------------------------------- <br />c <br />________ _______ <br />~'fJ' //~ //~ __________________________ <br />____ - <br />Dfnnager_- t,.C____~j~.L_-___ <br />' NnApea of Owners P. 0. Addressee <br />----f~----rl~.~:~- ---------------- --- <br />- ------------- <br />---1_L~__7tz.~ ct_--------------- - <br />___ __________ <br />lianngur__________ _ <br />S~ntc mimes of claims: <br />,/ ~ ~ P/gtented- CC~^ ,S Unpatentcd <br />---------------------------------------------- <br />---------------------------------------------- <br />'i~~L•tl acreage patented________________________ acres; unputented______________ ____ __ __acres. <br />- --~ -- <br />Company. ' <br />'Do you own or ]ease these claimei__' tG ~_____________________ _______________ ______ <br />.________ !f you Icase them give name f ompnay or person frma whom lenaed_c.}_-LO_~1L__~t___rl_C:L'G1/_2__ <br />(Over) <br />