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Name of ] <br />Date of Oi <br />Location - <br />\[iniag District--------C (J='?y7~~--------- --------------- <br />----------/ ' /' <br />County of___=01~=------State of Colorado. <br />Title------ ~---------- - onr: <br />---------------- <br />vested in----_-___-- - -- ----- <br />Principal Office Located at____________ <br />Branch Office at----------------°-----•------------------------'- <br />Name and Address Ogicers----------------------------------------- <br />Altitude at 1lfain Workings_______~~~________ _ ________ <br />Character of Country Rock _______ ----------- <br />_ ~' __Acres, <br />Character of Vein ------------------ ------------- - ------:-------------------------.._----- <br />C6aract of Walls or Enclosing Rocks _-"--------`~Z~=~~ ---°-°-----°--------°-- <br />Character of Ore `(~ ----------' __-'- "------------------ <br />Orc Occurrence--------- ---------- -...-----•--------------------------••--- <br />----° <br />Devclopntcnt, Vcntilatiou, Sanitary Couditiou, 13xlts.._..~'~'e!-'f-`~/- -- -•-- <br />- -- - --- --------- <br />- - - -------- - -- p_~~~ --2.~ <br />.. .. .lam <br />_. .. <br />U_ _ .m <br />sz <br />'I~ <br />I <br />IG <br />