MINEBK00175

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

1 ` ~'
easing eom. MINE REPORT ~ 1
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~ Note-Please 8ll oat this report carefully, write plainly and answer all questions fully. Be sure to
.____ date the report and sign it. Fill oat both sides of the sheet.
J •
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1i~ ---•- - ----- -------------- Colorado, --------LC_V_K..__S-_, 19,3
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___ ht. BL"RE9li OF 11LINES, STATE OF COLOR_11D0.
------' '` T. R. Hennhen, Commissioner of 'tIines,
------- Denser, Colorado.
-°--'-'-- Sir: In accordance ~sith Section 4299, Revised totes, Colorado, 1908, I submit report ns follows:
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~~ame of Company-The-------- - - _/_~%~''_-~~ NO _COmpflnY.------
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~Incor orated in the State of___ NO InCO2'pOr8t1_oij__________________ '
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~Principal office _____________ _ fS~lw.oehn,~~c___.
u • wm~.°r, i Capita] stock ___-____ NOn9 _____ __-. , -_ Shares, at ~___t1_Q11~.__ _ per share.
cu °°~ n Knme
hoar shift. !v~~ °'h~" - P. 0. Addresses
,...:, It al,°t None '
hoursldit. ;President ------------------------------------ ------------------------ --
hourshift. (Secretary NOne
hour shift. !Treasurer ____N9 _ _ ___ _ _ _____ _ -- ____-- -----_--_-- ----_--_--
~~°,-~- -_-- - 4
hourshift. illanager ___'1i~-- _____.__ --Leaaee_ 205iE.~th.,3t_~L.@adV,111e
hour sf:ift. -
hourshift. rTitle of Partnership_NO_Partnerehlp,Le~QS_-helst_bY__T.F,.Oi.1T.oY....__
hour shift. Partm~rs' Xumes P. 0. Address
hour shift. I---- ----------.---------------------_-_.-- 20.5.,)~,4th.,-St-.Le&s1V111e _
tour shift. - ---- -------------------- --------------~- -~ ~----- ~ ----
I- ~-- - - ----
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vm. is LI•nk I
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i`Dlanuger-. Leaaee.
--- I Values of Owuers P. 0. Addresses
'-- - Heim of_Maurice_SCOtt._ nenver,Col9Tado.
---- - ~Eatate_of J.E.Haveno:-b1.E.BOU~k.Executor-Denver, Colo.. ,_ 1
_ - __. _..
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~, 1,.,,~ Chaa.J.Yoore. Equitable Building, Denver,COlorado '
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::. owl wy - _..__-.._______ _________._.-.- ___
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-_-. .Manager _. -.- - -. - -
.~._- .'~:~,. ualw:s of claims:
_ Iklpulcn U:d
1 ulen ed
~ in the /~ __ - ... .-_
------ __ 1/ _ - - _ --- - - -~ ..- -
Llttl~_. a).e$_ ~_ - -- _ -
- -- -
--- --
- - -- ---- --
>9hite Prinoe -
acres.
- --- 'l'ore.( ;:cr,:uge yuteuted__3~- -- -_ _acres; uupatcutcd_ ..Nfl.I10._
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'mpBDY' ~Y/ S/~'- - -
Lo you own or lease these clulmst___ . --
----'-- If you lease them give Hume of company or person from ed onn leased.. I)Bnera. 1
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---- ----- - - (Over) / yYlnwwv` ~ ~ ~ly 1 L
~ VtII rel/ /o~a~
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