MINEBK00175

• County: Lake
• Document: Manager
• Suffix: A

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MINE REPORT ~~ ~
Note-Please fill out this report carefully, write plainly and answer all questions fully. Be sure to I~
date the report and sign it. FilLont both sides of the sheet.
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--~---------------. Colorado, -------------------------,19---
BtiREAli OF 9fIIQES, STATE OF COLORADO.
T. R. Henahen, Commissioner of Mines,
Denver, Colorado.
Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1008, I submit report as follows:
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fATame of Compsay-The____:~,,~~ /
Incorporated in t State of_~4~ ~r~~~___`f ~~---------
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Principal of6ce~~,~+,~ >G~`~`~~~~ --- ~,~~'Z`_ _
Ca ttal stoc): l/• Shares, at ti_ 1%/ .
1! a Com act. ~ P' --?~_l/_ _ _!/G G 7 ~ f C/. ~ p~~~~di
eu o~r'~'' ~ Presiden~~- Nnme~~j~t.Z~l~ ~•__ • Addres s ,~~
lart It Llank ~~/~,[ ~ ~/
ISeeretary /_/_•_ ------------- -------- l.E~a'p-.~c~- _ ~ ~~~e~d!-;
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; Treasurer _ ~ _-- -- ~ ___-- _-- _-!/- ~~
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".1lanager -~-~~_ --~ .et-~c.~>4..e,.v-..~---- ~`-~~~IOJr--
v . crm
or vmunetilp.
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rytu~. o'Lrrr.Lt
~n~. It blu:k
Title of Partnership------------- ----- - ---------------------- -- ----- -- --
Partr.~•r~' .`;:uu:•= I'. 0.:lddress
~Jfanagcr__ _-_-___ - --___._____._____. -
r Names of Owners
I - - ----- -------------------- -
'_M1fannger- - --- - -- ----- -
swb: names of claims:

'~~ ~r'~Patented I?npntentud
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.-._,.~..........-rrt ----------------- -- -
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-' -----
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'1'otul~ecrea e---------------------/ _------- gores; unpatented_-___-- _----- - acres.
g patented------------------
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Do you own or lease these claimet__ - -----°'---""--------- -
uyou lease them give name of company or person from whom Iensed_______-.- _ .-- ------------
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