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:; <br />~~ <br />MINE REPORT <br />Note-Please 8ll out this report carefully, write plainly and answer all questions folly. Be sere to <br />rt and sign it. Fill out both sides of the sheet. <br />~ I'~ <br />i. <br />Y.. <br />date the repo <br />~ jam/ / <br />`, IZ~"------------~ Colorado, °G ~-~i~!_l_~~.19<~ <br />,~- i3UR1;AU OF DUNES, STATE OF COLORADO. <br />- T. R. Henahen, Commissioner of Dlines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, P,.evised Statatea, Colorado, 1908, I submit report as follows: <br />Name of Company-The --_-_ ~ j~~~~~ ~ <br />Incorporated in the State of___ __ --------------------'------"'---' <br />Principal office~/_!1'~~--~j-~ ---`~"- -"-"------- --- ~ -------------------- <br />Capital stock t_~ ~~~----------- Shores, at $ ~=~--- Per shore. <br />It . Cnmwnr. Nome P. 0. Addressee <br />pp out thV ~ ~ /1 <br />q.cr; otner~lw ~ITjyl J''ty <br />I...e It Dlank ~ _ _ _ ~- _______ J <br />President _._ - ----------------- <br />-- - ,-~ <br />-------------- <br />---------- <br />Secretary _ / - - ~ - --- - <br />-- <br />----------- ------- <br />e rer ~~; ~- - /- ~ /' <br />------C ¢'-~ <br />-. <br />----------------- <br />p-- - ---------------------------- <br />^'itle of Partnerahi <br />Partncrs' Xnnus ---- P. 0. Address <br />------------------ <br />s . er,„ ----- -- <br />ur Vvrtnrr.DlD. ----------~------- <br />- ----- <br />nnn~tml• ------------------------ <br />qmm; o[berwiw <br />leer It nlaok - -~~------_---- <br />_____ <br />D anugcr----------- -------------------- <br />Nnmes of Owners I'. 0. Addresses <br />--- - --- - <br />I ------ ..-------.. <br />------ <br />1! anther ------------------------ <br />pnup.nr nor _______ _- _____________ <br />p_rturMJg _________ _ _..__-.______ <br />(.:I UUI LJL _ <br />^I'ece <br />___ . <br />_______. <br />~~ATunager --- - -- - ---------- - <br />.~ <br />1, <br />~I~ <br />tale <br />,(t <br />1 <br />'.ante nuiues of claims: <br />Patented Unputente <br />L - ~ _ --~~%------------------ <br />- - -'------ ~'-------•~---- ~ .tc...- <br />--- ~~ - - _ <br />----------------- <br />-------- ~-`------..'- acres. <br />---- -. <br />_~- <br />-_ -___ ~ atented__ <br />Total acreage patented_~~~_f ______-- acres. unp '_- 2~.,~ <br />----- <br />Oo you o n o se t e e ai f~ltJd--~~ S.°~~~""'~'"• <br />~' erson Yrom whom lease •/ ~f' <br />m P <br />~~ <br />' i.- <br />.____Le~_ •~ -___---- <br />~a'~"ZG- - - --"----- <br />r ------- i0ver) 1 ^~tr <br />~.~i,.M~wu.L ~ R~ 1' rv ~.^^'~ ~i17~ U'.~. ;~..-~ G~~ ~-Ghr <br />t/w <br />p.~,~v <br />!-7 ~ ! i~ l,, `~ <br />( ~, <br />~~ ~'i <br />n <br />I, '; <br />~~ 11 <br />rl <br />~~ <br />J <br />- 7r <br />1 <br />