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I <br />Natne of Mine----"-~!D_'~__-------------°--------------'-°-- ~- I~ <br />Dale of Original ocation __ _ ___ ___ ~ ~, <br />'---r~q <br />/p,~/r~ ~_~ ~_~_ ~/ ~_____~C~y __!~__~~____~/_______ IH <br />Location .____ ~ ° 4 I~~ ~ <br />Min~Distnct. l/~¢ ~ -----------'---------'------------~- - ~. <br />County oL. _____ ______ ___State of Colorado. Q Acres i <br />'fitle._____ ___ ________`_"^'S^_^_=!__.~/JJ_~___p___~_____ ____r containing .,~ KZ , <br />i ~~ <br />- - - -- -- -- -- - --`~-------'-y-(-gyp--,-,y-G~y~---°-----'------- ' <br />Yrinctpal Office located at_- ---- ------L~-a __ ~^_"'~f/-C'-- -.~~.---/p~-------------------- ~i ~,,;I~~ <br />Branch Office at ------ -----"- -----° ~~O -------' -------: f~ ~tl' <br />Natne apn~d~A~dd~re~ss..,Off_icers-~- p------- ---- ---- f `~~7~~~~~A-`-°" ~~' ~{ <br />~r, _ _ -v ~.....~ .~.-F ~,- -.._. <br />------- -I- ---- ------°- <br />- - - - <br />/J~J ~~ ~p - ------- --------'--- <br />-Q/ /6 np r <br />Course of Clain t..~"_J~_°_~-"'----"'--Strike of leiu ._v~_ ~s SY <br />o ,c <br />f--- ~1a=- ,~ <br />tttude at Main Wor ings -_--- -------`---'--'--°--'-__.__ ---'--- - <br />Character of Country ~~hoc//k ~~-'1fiL~4=E'!l~e-'~'--- ---- - _. <br />Churucter of Veiu_.-_'cC..~e~9r_c~e~t.C- -------- ---~----------"--`----------~~----------- <br />Character of Walls or L;uelosiug Rocks.__ __----___-_- ~t-----------° - <br />Charucter of Ure -~..~=~ ~, y~ q~ ~~5~.1--~---- ---- - -- <br />-- -- ~lttll_i-~ <br />-~~~- - - ' <br />o--- <br />_ - - -.. <br />On O t r tce~ G'O <br />-- - - <br />' - <br />------ - -: ---r---/ <br />--- (rte <br />1)ey~rlopmeul, Veulilultou, SuuilurY/JCottdrtiou, ] ~il+ /s - ,/ <br />1lp i LJ ~~ i`O ~' JLL fl Y/~ <br />-- -- _. <br />_ _ . -- <br />- -..._ _ <br />. _. . <br />~( <br />/~iS~"jjC.a~r.t..~t~':. / f t' ~c:f-1(:_J ] ~',._ t/..c-wsiG~i_ ~"'p-~`-~ <br />~/f18 X ~. y ~` ri ~,~ r~ Gt:--v-H.c .~./ x' :~d ~~('r N~Q-e~1r~ (/'~-urc~-y <br />