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~i0II11~~ i p~//~ 1J~u <br />- -MINE REPORT <br />_enty__yebre. <br />L___________.. <br />_,_kunk_ house <br />lee-n_nF~-Toted <br />Note-Please flll out this report carefully, write plainly and answer all gnestiona folly. Be sore to <br />date the report and sign it. Fill out botch s~idesof,the sheet. l < jJ11 <br />------------- ~~t/__`~__, Colorado, ---~f~~ ~4!~ ,~19~C]~ <br />BUREAU OF b1INES, STATE OF COLORADO. / <br />T. R. ]Iennhen, Commissioner o4 1lfinen, <br />Denver, Colorado. <br />Sir: In aecordnnce with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />If ~ CampW. <br />GII out t b <br />rp~ro• oNtrwlN <br />lure It hltnk <br />u .arm <br />or D~rtnenhlp, <br />EII out lhb <br />rp~ro; atherwW <br />lure It blink <br />Ir nellber <br />comp~nl not <br />partnenhiy~ <br />011 out tub <br />m.ro <br />'Name of Compnny-The~!1Ly_~utw ~lvvvv~____~rv_u%y_vvy --~- - --- <br />Incorporated in the State of_____________________..________________________________ <br />Principal offico -----------------------------------------------------------------.. <br />Capital stock ___________________________ Sllaree, at $____________ per shore. <br />Nome P. 0. Addresses <br />President --------------------------------------- <br />Secretnry --------------------------------------- <br />Treasurer -------------------------------------- <br />1lfnnnger --------------------------------------- <br />..1lanngcr------------------------------------ --------------------------------- <br />Title oP Pnrtnerehip___~,p t,T == ~ti __~_'=',-fzt/ _-= '~c,i<~~ ----- <br />~J Pnrtnere' Namrs ~P~. O~/Addr~ess ~/C//~,~~ <br />([ .,i-~f~„-~S~_" _'YJ-~/----- 1i~-"~ `.PLC/ <br />/~ ~ 5+ /~9~~a ~o _ -fir <br />---- `-------- -`=--fu-`---- - ----- ------ -----°-------------------------- <br />------------------------ <br />\tanneer________________ <br />/J~~ ~Nn s of wners <br />~~~llU_~~J---- - - ---JJ--- -- - <br />_ - _ ___ __ _C_ <br />/~ <br />------------------------------------------- <br />___________________________________________ <br />~,~P,,.~O~~. Addreasca <br />____-~~ic~!/vm__~C~_____-_____ <br />(42~ <br />State names of claims: <br />Patented Unpatentelt <br />~~ I .L_ f-~! : C.fi!.~'--------- <br />•------ - /J ------ ---------- -------------------------------------------- <br />_______ ~- c2~ ~_!~____________ ~ ______________________________________________ <br />-- r---~ ----.. <br />'I'otul ncrcage patented_________________________acree• unpntented__--____-____________-----_ncrea <br />Do yon own or leans these clnimnt________________ - ---_----- <br />If yolf lease them give name of Compnny or pernon from whom lensed___ ~ -!~%!-~~1!?~~_____- -- <br />'~A i i <br />~.' ~- (Over) .i ~ r .1~~~ -~ <br />~r l- /~-~la.. 7_!.! /'~. (~ c ~t li..rf~ ./)"`/.= C'7 ! i J 'oL0 <br />__ ~ / l <br />i' ... +, <br />