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,l t~ <br />MINE REPORT 1 <br />Note-Please fill out this report carefully, write plainly and answer all questions folly. Be sere to <br />date the report and sign it. F,i~ll~out both sides of the sheet. n <br />~(!(l_~1f'?:~_~_'_/ ---, Colorado, --~../~(~~/t! ~~, 19~-~ <br />BUREAU OF b1INES, STATE OF COLORADO. <br />T. R. IIenahen, Commissioner of 'clines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />If ~ Camp~1. <br />CII out t dr <br />nyxc oihenrLt <br />Nave It Llmk <br />If ~ Orm <br />or ponnmhlp, <br />All out thb <br />qmn~; of hervbe <br />Iram It blink <br />Name of Company-The--------------------------------- ------------------------ <br />Inoorporated in the State of______________.-.-_-------------------------.----____-- <br />Principal oEiice -------------------------- ----------- ------------------ ------.. <br />Capital stock --------------------.- - - _ Shares, at $__________._ per shore. <br />NBmC P. O. Addresses <br />President __ ----------------------------------- ------------------------ -- <br />Secretary ---- ---------------------------------- ----------..__....-------------- <br />Treaeurer -------------------------------------- ------ -------------- <br />'tianager -------------------------------------- - ----------- ------ - ----- <br />~, - t <br />"Title of Partnership_____~~~~~.~%_/-----~--~~~=4-- ----- <br />~~~ Partin n' \ulnes /mil'. 0. Addre <br />_ t'`~-ice-- - ~"~'~ - ----- - - f'~G~-~l~~ _1. ~. - <br />-~'~~~r'~'`-Q`'~~-~- --------' --'- -- - . -- - <br /> <br />Numex of Owaers <br /> <br />rt ur¢h.r <br />inpsor nor <br />~~;n~.rr~nlp. <br />f.ll nut rule <br />.I,.rr <br />6lunilgcr _ _. - - - - <br />ald~ names of claims: <br />Patented <br />. ~~~~~r_~1__Gr~~_C~z~- - <br />~ , 4 , ~~ , „-,~- <br />`~-=--"-T--~------~----------- -----~ <br />-._ ~.-~ _ <br />I'. 0. Addresscx <br />llupnUvlted <br />,I <br />l <br />f <br />;, <br />,,. <br />/V <br />j <br /> <br />- -- - - _ - _.._ 1 <br />.ttl•rea. <br />t 'llltnl acreage patented__.~~~`--~---------uf•res; uupulcuted_ -_...- - - <br />/ - - _ <br />1)o You own or lease these clnimsi__-___-~.C. G !~~`-'--£-------- "-- ~ -- ~ -- - - <br />lf y~nl lease them give name of company or person t'rum ~rLum le+tscd-- - - <br />,L,L. _ - <br />loser) ~ ~i <br />~ n <br />;~ <br />