Laserfiche WebLink
a- <br />f '7 <br />MINE REPORT <br />Note-Please fill out this report carefully, write plainly and answer all questions fully, Be sure to <br />date the report and sign it. Fill out both aides of the sheet. ~~ _A <br />- - ~f_?~, ,-rr _o_ ~e-%trv~ --. Colorado, -- c?/! o'L~ _ /_ 11^ ~' 19/_ e3. <br />1 <br />BtiRF.9U OF AiINES, STATE OF COLORADO. <br />T. R. Henahen, Commissioner of Afinea, <br />Denvet, Colorado. <br />Sir: In accordance with Section 4293, Revised Statutes, Colorado, 1908, I submit report ns follows: <br />if • Comppav), <br />LII out thl. <br />.peer; otkenrLa <br />trove It Llank <br />If .arm <br />ar p.nn.,.n+v. <br />all ~m na. <br />.parr, otLrrwlae <br />bm It Llank <br />I: u•itlmr <br />urigmur nor <br />p~~rturraLl , <br />.I,~ . <br />;Name of Company-The--------------------------------------------------------- <br />Iucorporated in the Stato af________________________________________ <br />Prineipnl office --------------------------------- - -- ---------------------- <br />Capital stock _______________________-_ _ Shares, nt $__________-_ per share. <br />h'nme P. 0. Addresses <br />President --------------------------------------- ------------------------ - - <br />Secretnry --------------------------------------- ----------- ------~--------- <br />Treasurer -------------------------------------- ---------------------- <br />)fanagcr --------- ----- ---- <br />Title of Partnership-------------------------------------------__--- <br />~ Partnl~rs' Vnmca Y. O. Address <br />Afanugcr---_ --- - -- -- ----- ----- _ _. - __ - <br />ATn111P Of OW C8 <br />' 0, Addressee <br />- - ~~u,o/=emu-- -. ~d.«~. <br />~~~~~ w <br />_ ~~ -- <br />-- ---- - - <br />~~ATunuger-~'~.~,jP _)-N/uV~iS~ _. _.. --..__.- <br />~~+:!~• n:unes of claims: / <br />Patented llup+ttruted <br />- -- -- <br />-li-'~1Q ---------------- <br />' ~ __ _ <br />--~r~a=~__~ --- - ----- <br />'fat nl acreage putcnted__------_--- sores; unpntented__ Worcs. <br />-- <br />Do you own or lease these clnimst_____:_~r~%~--~T----------- - ~ ~ -- <br />1f you ~as/e them give uume/of company or person Yrayu whom lensed-~ ~'-'-' <br />(Over) <br />i I ~! <br />f <br /> <br /> <br /> 1t <br /> I( <br />1 <br /> I <br />h II <br />Ij ±I <br />I <br />~i <br /> <br />