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-------------~~'°".f--------~ Colorado, - - - - ---~--------~ 19~~' <br />r <br />IiI;RF.AU OF 11fINES, STATE OF COLORADO. <br />'I'. R. Hennlien, Commissioner of bfines, ,~ <br />Denveg Colorado. , <br />Sir: In accordance with Scetion 4299, Revised Statutes, Colorado, 1908, I submit report sa follows: <br />MINE REPORT ~, <br />Note-Please fill out this report carefully, write plainly and answer all questions folly. Be sure to <br />date the report and sign it. Fill out both aides of the sheet. <br />1 <br />~. -~: <br />ame oP Company-Tl~e---------------------------------------------------------- <br />icorpornted in the State oP______________________________________________________ <br />rincipal o0ice ------------------------------------------------------------------ <br />npital stock ___________________________ Shares, at ~____________ Per share. <br />Nome P. O. Addresses <br />'resident --------------------------------------- ----------------------------- <br />ecretnry --------------------------------------- ----------------------------- <br />'rensurer -------------------------------------- ----------------------------- <br />lnnnger --------------------------------------- ----------------------------- <br />of Partncrship-------------------------------------------------------------- <br />Pnrtners' Names P. O. Address <br />ry ,~`. <br />.«___-=- s~~1 <br />12."-- <br />irkmen in the <br />_.~~ c.~ <br />----Company. <br />--- <br />-------------------------------------------- --------------------------------- <br />1lnnnger------------------------------------ --------------------------------- <br />Names of Owners <br />~ Y I;I <br />P. O. Addressee <br />L~zk?ly(~-------- ---- -- <br />-------------------------------------------- --------------------------------- <br />- ----- -- --------------------------------- <br />--- <br />- - <br />- -- <br />--- <br />--------------- - <br />Dinnngcr-- - --_!f~ --------------------------------- <br />titute nauus of claims: <br />Patented y~ ~ ~ ~Unpnten ~ ~p~ <br />- -------------- ~ -- U / <br />~ , <br />~• , <br />-----------c-L.G~S JcL S-=~------ ------------- <br />'rotnl acreage patented-------------------------acres; unpatented________-------------------acres <br />1)o you own or lease these claimst-----------------------=--------------------------------------- <br />If You lease them give name of company or person from whom letieed-------------------------------- <br />(Over) <br />