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~ , I <br />_\ <br />- l <br />I ~+ <br />=`~~ MINE RE ,.~ I° ! <br />I :~ POR t <br />Note-Please Sll out this report carefully, write plainly and answer all questions folly. 3e sure to -t <br />date the report and sign it. Fill out both sides of the sheet. <br />n ~ ,~ <br />-, , <br />Colorado, 1,,~ <br />BliREAU OF 11IINES, STATE OF COLORADO. <br />T. R. $enahen, Commissioner of ,liinea, <br />Denver, Colorado. <br />`1 <br />Sir: In accordance with Section 4299, Re~dsed Statutes, Colorado, 1908, I submit report ns follows: I <br />t <br />Nome of Company-The---------------------------------------------------------- ~~ <br />Iacorpornted is the State of_____________________._______._________-______________ <br />Principal office __------------------------------------ <br />Capitnl stock ___________________________ $hnres, at $____________ per share. <br />I! . comp.nr. <br />ml one t 1. ATnme <br />,I„rr; ou,~.. P. 0. Addresses <br />Invr It nlmk <br />President ----------- ---------------- - <br />Secretary _ _..---------------------- <br />----- ------------------ <br />I <br />Treasurer ------------------------------------- ---------- ------------------ 1 <br />Manager ______________ <br />----- ~--~ , f --,-----~ - ------ ---/J ---------------- <br />/^ .~~ <br />1'itlc of Partnership___ _ `____O ~_{.t,.~t<_~a-~__1 ____~- <br />--'--- <br />------ <br />Partm•rx'-Rumcs ~ Y. 0. AI rcas <br />--~"E- -U -~c~-; c,-L/iii -- --- ~ --- ---- -- <br />-- --~~-- ^- - /y~' <br />_..r.. _ <br />,~ ~ , /~ r /~ C~ s_, r~ !J <br />u . eon ~ i~ ,: --- <br />ar Vurtnrvhlp, ~ ' <br />q nr nenrrwlu ~ , 1 .. <br />~.. t-.___ ,-___ _ _____ ..__-___. _- _ .~__ ~R 1~____ <br />-- <br />I Names of Ownc e - --- - P. 0. Addresses ~ <br />I!uritnrr I_-_____. _____.__________.. ..- _ _ <br />r <br />~^~I~.nr nor <br />Varwrrxhl . I <br />ru n„Iw ._ _______-___________ <br />~p¢e <br />I - .... _. __ _ _. - <br />.___. <br />ti tial~• owned of cluilna: <br />~, Patented ~ Cupnteutcu <br />_ _ ~,. <br />_ - - '-L-~-~--'----~.1C L. __.. - _ __ .._ -_.._. - <br />, <br />__ .. _ <br />' -- <br />'I'uLll acreage ~lutmited_. _-_- ' _-.. --xtvra; unputented_. _ <br />Do you own or lease Uleac cluilnai___-_--. ---------- ----- - ,. _. -._ <br />lty~n Ivusc them give name of company or person from wlunn lenxed_ t~...~-~~5yf~'f"'C"~~f~ ` <br />.(Oyer) <br /> <br /> <br /> <br />I~: <br />II <br />,1 <br />}f <br />I~ <br />I~ <br />~I <br />