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<br />sing com- <br />.D- - <br />.a_ <br />'Br? Y~OSi'1rE <br />:,,. PS.1310. <br />-a.32)A- j'"117^ <br />l..]~_ <br />our etlift. <br />our shift. <br />our shift. <br />our shift. <br />our shift. <br />our shift. <br />our sll ift. <br />our shift. <br />our shift. <br />our ahiR. <br />our shift. <br />C^rr;ttr ~~' 1~ ~ <br />~~ <br />/,,-., `~ <br />MINE REPORT rte, <br />Note-Please fill out this report carefully, write plainly and answer all questions folly. Be sere to <br />date the report and sign it. Fill out both sides of the sheet. <br />• ~ 7fi <br />BURF,AU OF i1fINES, STATE OF COLOR 0. <br />T. R. 73enahen, Commissioner of _llines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />11 a Com anr, <br />011 out [Pb <br />ryace: otLmrW <br />la.r It blank <br />A'nme of Company-The_______ _____ <br />Incorporated in the State of__~_____________________________________________ <br />Principal office ------------------ ------------------------~ <br />----- - - - <br />Cnpital stock ______________________-__-_,_ cores, nt $____________ per share. <br />Name P. 0. Addresses <br />President --------- ------ -- - -- ----~,---------------------- <br />- -------- ----- - <br />Secretary _______________ <br />------ <br />Treasurer ------------------ ----- -- - ~. <br />1lnnager ------------------------ ------------ ---------------- ~------- --- <br />of Partnergbip--------------- ------ ------------------------------- <br />Party~rs' \emcs P. 0. Address <br />If a Arm <br />or VonnenWO. <br />III uu[ thb <br />ryrcr; n[hrvW <br />Im~r It Llmk <br />~ __ .. - <br />_. _ _. <br />----- ~linnugcr_----------- <br />-- -~- r Num~aof wn•rs <br />"---- ~~ pear nor / '- <br />--- p•numLlyy ~ <br />III colt 4~b ~ '-~,/ <br />____. q,rte I v <br />i <br />n in the <br />_ties _?'zor <br />i_ke_s1r.lY <br />:ret iu~ : , ;, <br />~~P--rel.I,rt <br />~aT <br />!,~_ ~~ <br />==1----- <br />....sL . <br />I,Alanagor-.-_.-_ _--_ _ ..-___ - <br />~Rtl~' all ml's OL ClalmB: <br />~` Patented <br />-----~--t--------- -------- ~- <br />"-~ <br />- ----- ..__a- --- ---- - -- <br />_._____-._-_ ~`r._ -_-_______._ <br />~~ <br />.____.. ______________Y---.__-.. <br />_.-_ _. <br />,~////P. 0. :lddresscs //' <br /> <br />IinpnUmtcd <br />I - - <br />~~ /~ --- - -- -- -ti- <br />- X11 ~L~ - -- ------------- - -- - ------.. ._ --- - -- <br />- ----- --- --------- <br />- --- - -- - <br />- _ -------- -----------Z?~P«Zi <br />acres. <br />'I'ut:a acreage lm uted__ ---acres; unpatented-- - -- <br />Do you own or lease these elaims4___Ll~ll~/ZL-i~1 ---'------"-- - - <br />lf yuu lease them give Hume of company or person Yrom whom leuaed_ - <br />--------- --- <br />(Over) <br /> <br />