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sing com- <br />a <br />4 ~{ <br />~------ <br />oar shift. <br />our shift. <br />our shift. <br />our shift. <br />our s}lift. <br />our shift. <br />our shift. <br />our shift. <br />our shift. <br />our shift. <br />~ir ~ift, <br />~ in the <br />- ~cwA~ x,~ <br />kmpaa~. <br />Cc~rz~ o~a~1C~ .~~~~~ <br />MINE REPORT ~ ~ ` <br />Note-Please fill oat this report carefully, write plainly and answer all questions fully, Be sure to <br />date the report and sign it. Fill oat both sides of the sheet. <br />_~.E~~~LYr~C --------. Colorado, _ ~h?/_~ --. 19_/ f3 <br />-- ~--L~. <br />BL'R1iAU OF I<IINES, STATE OF COLORADO. <br />T. Pt. Henahen, Commissioner of lfines, <br />Dancer, Colorado. <br />Sir: In accordance with Section 4299, Ret~sedStatutes, Colorado, 1908, I submit report ns follows: <br />1! . Com~.nr, <br />All out t d. <br />.MR: ntnt~.!~ <br />Irn'r It nl~nk <br />u .arm <br />ar Dnrtumhip, <br />All om IhL <br />rya: atherd.e <br />la.r It himk <br />c tmlui.r <br />runpmnJ nor <br />panv~mhly, <br />All uut tiri. <br />•{na <br />Name of Company-The_____ <br />(Incorporated in the State of_ <br />(Principal office _____________ <br />~Capitnl stock ___________________________Shares, at ~____________ per share. <br />~ Kama P. 0. Addresses <br />President _______________ <br />Secretary ---------------------------- --------- <br />---------------------------- <br />ITreasurer --------------------------------- - <br />--- <br />I ---------- -- --------------- <br />~4fanager --------------------------------------- <br />~' - ----------Q---/----/~----- <br />~7ritle of Partnerehi ~~ / ~ ~-~/ ~/ <br />p------------ ~-~~-`-'~------ ~`"-°-----------'~-F <br />Partners' \nmes Y. 0. Address <br />--- ~-'~--'ma`y`-`y=,~~~~-~-~--~-~------ - ---~~=~'-~~-~-'=~---- <br />--- ------'-/-~ ,A--~-~-'-~-~-"-- -------fit `----- u <br />I ///j~' / .~.- / <br />/{• ~ h <br />_.___ <br />( Names of Owners P. 0. Addresses <br />I -_ __-__-. - <br />~~~lana6'CL _________.___-___-__-... __ ___... ___. _. _. --.. _ -.. _ <br />51,t1~~ names of elnims: <br />Patented Unpatented <br />-- ---- - <br />~/1 .o-u~ /~/ -~-----------------' <br />..Jt .~.~~ _[~C~c.~c.C. __ -._ ---- - ~- - -- <br />/~~ ~ ~ ~__ ._ -_. <br />-""""+--0~"4.. C~91 Z -- - - - -- -- <br />----- --------------- <br />'1'ut.J t • 7- '~~ acres; ua /utented - - -- ~ - acres. <br />~reuge patentt,d__~'-'"'"~--- I <br />Do you own or lease these claims4_ ~'~-~~~-~ ~u`~~-p~p,~/r~ -5/ - - --- <br />11 'cu Icuse them n'e name of company or arson 1'rma whan Irused__°S!-~~~ r ~ ~" ~''~-'S"i' - <br />~ s' <br />1~ , -~~~ ~-- ~r-------- ----- -_ _ ~------- - - - <br />(Ocer) <br />~~ <br />I~ <br />~! <br />i <br />i <br />f <br />