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,j-~ ,~ ~/~ ,, <br />L~-~ ~ e <br />i r. <br />MINE REPORT . - <br />Nate-Please fill oat this report carefully, write plainly and answer all gnestians folly. Be sore to <br />date the report and sign it. Fill oat both sides of the sheet. <br />. o_ <br />` ____, Colorado, ~ • __, 19.__ <br />--`----=------------------ --=---------~-------r <br />CitiREAU OF DfINES, STATE OF COLORADO. <br />T. R. IIcnahen, Commissioner of 11lines, <br />Denver, Colorado. <br />follov~: <br />port <br />as <br />Sir: In accordance with Section 4°99, Revised Statutes, Colorado, 1908, I submit re <br />w= ~ <br />__ <br />~ <br />Er <br />Th <br />' <br />= J <br />~ <br />/ <br />~-`~-~1~!`~ <br />-- <br />___ <br />_ <br />e____ <br />~ <br />eme of Com nn - <br />rA <br />P Y l)-- <br />~ ------- <br /> ~- v - ~~ <br />, <br />incorporated to the State of--__/___~._sr-~r~'~s_____________________________ <br /> ~ <br />~ <br />~ n~ <br /> Principal office ------ <br />---- ------- <br />= <br />--=- ---- ------ ---- ---------------.. <br />= <br /> ~ _ ; <br />Capital stock ~ ' <----=---- -Shores, <br />--- <br />~ <br />nt .$_~_<_____-- Per share. <br />If ~ Companl. <br />C71 out [ ~b ~ <br />tame P, 0, AddrCSSCS <br /> <br />~ <br />r <br />irne It Ll~nk d i' ~ ~ f ~ <br />~ <br />4= <br />e <br />} <br />il <br />~~ ~' <br />------------% <br />-l-'-- <br /> --- <br />/--------- <br />President--t'":r-t <br />r-- -` <br />,c-Gj <br />' <br />G <br />i i, <br />- <br />.. <br />~ <br />~`_`~ <br />~ <br />~ <br />' <br /> _~_/ <br />Secretary -~----L'_'~;- <br />------ <br />_ <br />- <br />--- <br />< <br />~ .- <br />--_ <br />- -~" <br />- <br />--- <br />---- <br />/ <br />z <br />f_ J <br />~ <br />~ <br />~ <br /> -C.C -- <br />`_¢'"t tr <br />~ Treasurer _~"~-_~c_`1_.:_1_ ~ <br />_. <br />G. <br />-==- <br />t'-"' <br />~-'-,~ <br />- -• <br />- <br /> ~`vo% <br />r L <br />r <br />~-r=~------- <br />` - --}-`~---f__e~_--`--- '-~--- <br /> w- <br />iAinnsgcr _ <br />---- <br />-- <br />_ <br />(Title of Partnership---------------- ------------- ------------- - -------- ----- <br />Pnrtncrs' ~nnu~s -- -I'. O..lddress <br />- - -- _ _ .. <br />_____ ___ _ __ <br />J _ _ _- ___ <br />u . C.m <br />ar VertnernklD, - - _ _ _ ~ ~ - <br />ml~~nud. - --~ - - .. - -- ---- _.. <br />.,,.r.: ~,I,~.~. <br />In•. Il Lbok _.--__ ____ _____ ____ _____- .-- ._______ <br />~Dlnnagcr__ _ _ <br />A'nmcx of Owners <br />u ..dm.r <br />mp~ur nor <br />i,om~.,dd ~. <br />.pm e <br />\tunugcr _ - - <br />-- ~ <br />Rllil~• nxmex of cluitnx: <br />P. O. AdJresxex <br />/ ~ P ten/tad ~/ / Iluputt~nted <br />7~ <br />2,t e-t+fl - - - ~ - ~ - - <br />__ <br />__ <br />~/ acres. <br />'I'~,tal ntrcuge patented----._..--_1~L_~'/_ -ucrex; unpnlenled_ <br />Uo you own or lease tlicxr, cluitneT__--.-- - - ....-------- ---_~ _. _ _ .. . <br />if you Icuse them give name of company or perxon from whont Icnxed_ <br />- - - - - - _ <br />-- - (Over) <br />I <br />, <br />!' <br />1~ . <br />'~ <br />I~ <br />1 <br />1 <br />~~ I' <br />l~ <br />I~ <br />I~ <br />I <br />i' <br />I~~ <br />