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O ~~ ~/~ <br />MINE REPORT "'"~ ~ <br />Note-Please fill out this report carefully, write plainly and answer all questions fully, Be sure to i <br />date the report and sign it. Fill out both sides of the sheet. / ~~~ i <br />--- -- - - _ ----------, Colorndo,`5c~.!J!.~~1~-_f~ ---, 19C~ <br />BUREAU OF' 11fINES, STATE OF COLORADO. <br />T. R. Aenahen, Commissioner of i<Iinea, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />Name of Company-The---------------------------------------------------------- <br />Incorpornted in the State of____________________.-________________________________ <br />Principal olfice --------------------------------------°--------------------------.. <br />Capital stock _________________________._ Shnrca, at :]:____________ per share. <br />If • C°mpan7, <br />nn °nt t 1. Name P. 0. Addresses <br />,puns: othenrW <br />kne I[ bloat <br />President -------------------------------------- <br />----------------------------- <br />Secretnry --------------------------------------- <br />---------------------------- <br />Treasurer ------------------------------------- <br />llnnngcr --------------- ----------------------------- <br />-~- /~----\------------- L~ / <br />Title of Partnsrship__~?~!_L~~~L, _~1_~%~l~ti~G~"---~'YG_-~3!~~_-_-------- <br />ssPartm•rs' 'Tunes P. 0.11ddress <br />J~ ~ ~ '~ <br />LI/~ _ _ _ _ _________ ______ _________-.__J_L____-.____________- <br />nf a arm 7 y <br />r pvrtnemhlp, / ~--- -__ ~_--_ <br />1111 out thiv _ __ _ _ _ _____________ ______________~t__.-___________-__ <br />vyvee: atbcrwlva ' <br />levy ft blank ~ _ -_~' -- ~ ' <br />----- - - ~~~,T ~~,// TTr--/~ ~~--------------- --------- ---------------------• <br />ifnnngc~~"t! ~/~l(_.4y~~_C!!i! d.riJ=~ =------ <br />Names of Owners <br />-------------------------------------------- <br />l\[anngcr----------------------------------- <br />titntc names of claims: <br />~ Patented <br />- ---i/lle.~u~c~c..occ-=r------------ ---- - -- <br />'t'otal acreage pntented____~~i~y ------ <br />Do you own or lease these elaims4_______ <br />if you lease hem give nam~f co 0 <br />-- ~----- Gj---~----/-~` <br />P. O. Addresses <br />------------------------- <br />Unpatented <br />---------------------------------------------- <br />acres; unpatented______________ ___---__---_uerea <br />from wham lensed________..-------------~-------; -,' <br />-~-~ <br />~~.mac/--------------------------- -- <br />ver) . <br />