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Oharacter and value of ore _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br />Name of mill {if any), character and capacity ------------- <br />------------------------------------------ <br />- Give n <br />____ _-------- FIII in <br />____________________________ Fail ou <br />________ <br />Character of surface improvements ----------------------- <br /> <br />~' <br />i. <br />'`4 Amount and character of ender-ground development <br />5 ',d <br />~~i3! .____________ <br />;.;!t _____________ <br />4: j~. _____________________________________________________ <br />,, ______ <br />., _.I. _________________________ <br />______ <br />__________________________________________________ <br />___ <br />~j <br />----------- -------- <br />tl~:a-._.. - <br />._ <br />iL.~~ --------------------- <br />Signed------=--~'~C~~~/-(/~Si_cw -- ~'~/J!4/L------ <br />