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;~~ <br /> <br />MINE REPORT , ~~; <br />Note-Please fill out this report carefully, write plainly and answer all questions fully. Be sure to <br />date the report and sign it. Fill out both sides of the sheet. <br />---------=„~`e~=`--`-tiA9-4~?-. Colorado, ---------\\~~'--------.19~ <br />BLAF.9U OF D'III~'ES, STATE OF COLORADO. <br />T. I:. Henahen, Commissioner of Mines, <br />Denser, Colorado. <br />Sir: In accordance with Section 4299, Rei-ised Statutes, Colorado, 1908, I submit report as follows: <br />r~ `~ <br />Vame of Company-The---!~~.ni.,,~--------- --~-------------------- <br />I~corporated in the State af_ +i.. ________________________ <br />Principal once ____ _. _ __ <br />a'~ <br />,Capital 6tOClL _______~d. __ SllarCa, at $__~__r____ per share. <br />1! • Caml~]. <br />611 ou: thla IQame <br />.~.n; om~.!~ P. 0. Addressee <br />parr It Llank <br />President _~_C_C_~_ ___________ ~;r~q~~_1.,..n~p/a, <br />Secretary C.-~~iwSa,J~r --------------- --------------~~-------------- <br />ITreasurer -----~~----------------------- - ----- --------------°------------- <br />~,3fanager --- - - --- - - --------------- --- '- - A~ <br />Title of Partnership-------__-----. -------------.--_._ <br />------------------------- <br />~ Partners' \nmeti 1'. 0. Address <br />1!a0rm __-__. _. _..__..____-.______.- <br />or parturnhtp, <br />Dl: w: thin _ _____________________.. _..-___. _______-___- _ __ - <br />rya^: a9mrdae I ~ ~ ~~ <br />Ins. it Llauk <br />I- -. - _. __ __ ____________ __ ___ _ -. -. _._ __________ __ <br />~~fanll(~Cr _____--_. _- -.__-__..-___________ __ <br />r Nmnee of Uwnere <br />rr~.~u~.n 1------------------------- <br />vnpnu~' uor i <br />pana~.rnLiV, <br />rr. .I _.-_.----__________________- <br />~~t u... ------- <br />^Ia1e <br />P. 0. Addressee <br />I <br />__.. <br />,Atunager- _--- - -----. - __ - <br />61et~~ m:wes of claims: <br />Putented 1!upulvuterl <br />Tutnl acreage patented__ ~q _ -.acres; unpalenUed_ - - - <br />ilo you own or lease these claims4_SS1.utsa-- ~-~~-~""~~~ ~~}~h <br />1f you L:uae them give name of company or person J'rom whom leased- <br />.. -'-------- --- <br />(Over) <br />:wren <br />~; ~~ <br />~; <br />i l <br /> <br />t1 <br />