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t <br />I ~ ion U <br />c' <br />MINE REPORT •t ~ -` <br />Note-Please Hll out this report carefully, write plainly and answer all questions fully. Be sure to <br />date the report and sign it. Fi11 out both sides of the sheet. <br />- -Sugar Lon*, __, Colorado ~Iovembor 16th <br />--------- ~ -------------------------~ 19 <br />BUREAU OF MINES, STATE OF COLORADO. <br />T. R. Aeaahen, Commissioner of 11lines, <br />Deaver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Co]orado, 1908, I submit report as follows: <br />'game of Company-The---------------------------------------------------------- <br />~Incorporated in the State of------------------------------------------------------ <br />Prinripal of&ce -------------------------- ----------- ----------------- <br />pa Capital stock __________..______________.._Shares, nt $____________ per share. <br />mi ~ i61a°'' IQame P. 0. Addresses <br />.wee: other•lae <br />lone 1[ honk <br />President --------------------------------------- -------------------------- -- <br />Secretary --------------------------------------- ----------------------------- <br />Trensnrer -------------------------------------- ----------------------------- <br />~3fanager ----------- ----------------------------- <br />Title of Partnership--------------------------------------------__-_-. <br />Partnrrs' Names P. 0. Address <br />II a arm <br />or yannenhip, ___ -_____.-_______________________ __ <br />anmrtwe ----------------------- ------------ <br />~k Wank <br />ilfanager------------ ------------------ --- -- ------------------- <br />Names of Owners P. O. Addresses <br />v.l+.~acelatyn. Guru:- ;,o~.,(,olu. <br />neither "--- -- --------- - - -- - - .. _ - .. - -- _.. . _ <br />e ~q enr our <br />1 +rti rtnhl , <br />Cl. vut thr - - _________________ _ ___ <br />.prce <br />lAtuuager -- -- _ --- ---- _ _ . . -- -- - <br />Strrt~• uumes of claims: <br />Patented Unputentrd <br />i-lpine i?orn. /,1pi,:c ;;orn :;o.;: <br />------------------------5 ------------- -- ------ ---------------- <br />7blul nereuge patented_________________________acres; uuputentud__ --.. acres <br />0 -- <br />. _ ---- <br />llo you own or lease these claimst__________. ___._n'_ -----------'- <br />lf you lease them give name of company or person Yrom whom leused________.-____ --- -- - - ---- - <br />(Over) <br />