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<br />~ /. <br />~ ~tiQ n <br />I :'' d <br />MINE REPORT <br />Note-Please fill out this report carefully, write plainly aad answer all questions folly. Be sure to <br />Sate the report and sign it.Fill ou~tbo_thosid~es of the ,shheet. ~~.~,~ <br />---/1~1~:,!/1,~?lL_O_L_, colorado, l.~G!I!_U____~~----, Isf3 <br />3UREAU OF i<IINES, STATE OF COLORADO. <br />T. R. lienalten, Commissioner of 11lines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Stntntes, Colorado, 1908,I submit report as follows: <br />If a Comppavr, <br />III out thb <br />gran' otherdw <br />Iru'e'It hunk <br />If ~ Erm <br />ar pnrtn•nhlp, <br />IIII uut WI. <br />,prr o:hrrwlw <br />Irm.r It hlmk <br />n mifher <br />impony nor <br />i~.rn..~rnhlp, <br />iin uut tui~ <br />Nome of Company-The---------------------------------------------------------- <br />Incorporated in the State of______________.______________________________._________ <br />Principal otEce -------------------------- --------------------------------------.. <br />Capital stock ________________________-__ Shores, at $____________ per share. <br />Nnmc P. O. Addresses <br />President -------------------------------------- <br />Secretary --------------------------------------- <br />Treasurer -------------------------------------- <br />Jfannger --------------------------------------- ---------- ---------- <br />'Title of Partnership----- _ .C1_.?/YL.srac.o~--C~.~~~_-------- <br />r,~ Partn~•f:ti' a Ics P. O. Address <br />~III21agCC _____ ___.. ._.. ..__..______..______. <br />r <br />I <br />Names cf Owners <br />P. ~. Add rC99e9 <br />,- <br />I, <br />~,l t ~~ <br />~;~' <br />,. <br />• /V <br />~I <br />~;I <br />~ ._ t <br />_ y---- --- <br />~~ ~ s/li f~c. ,~ ~yG_ . fJ?t. -~ _ . ~/.~'~.rf~u ~_ ~oPv~~ <br />1 ~ ~iafstLl.PGG4N_/fiC. <br />' ltunugcr .. ,1 <br />:~I.dc names of claims: <br />Patented <br /> <br />Unpntcn[cd <br />ucren. <br />'1'vtal :ICreugt: pntented__-.--_-------------acres; uupuGfnted_. -. ---~ - <br />I)o you own or lease these claimei'______y~ ~CCT/It_'ei-~-~--'~~y~ ~~ <br />if you lease them give Hume of com ~n~yor p~er~so~n~~Yrow w!uxn leased--`/," <br />O ver) <br />~~1 <br />~,1 <br />.4411I <br />I <br />d <br /> <br />