MINEBK00285

• County: Boulder
• Document: Manager
• Suffix: A

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MINE REPORT - ~' ` ~ g
Note-Please fill out this report carefully, write plminlp and answer all questions fully. Be sure to ~.
date the report and sign it. ` E'ill out both--sides of the sheet.:. ' '
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~o r~-z ~-"~__, Colorado,~~~~~~_~~~____ f~_ , 191
BUREAU OP MINE ~ STATE`OF<COLORADO.
T. R. Ilenahen, Commissioner of Mines,
- Denver, Colorado'. p
Sir: In'acccrdanee with Section 4299, Revised'Statutes, Colorado, 1908, I snbmit report as follows-i-
Name of Company-The_-`- --' --- -- --- ---
' Incorporated in the State of-- ---- --- --- ----= --- ----- ---- ---- --
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Principal offiee -- -- `---- ------ --- --- - -- - ----~' '
------- I
Captal stock' _______ ___ _____ _ Shares, at $__ ___ per share. 1
v a com .nr:
eu oat t~;, Name P. 0. Addresaea- .:
apace: otherwLa - 33
leave it bLnt ° 1
Freaident ------- - ---- ---------- ------ - -- ---------------- ------
Secretary:------------- --------- --------- - ------ - ---- - --- :,
Treasurer _-` - ---- -_ - - -- - ---
Manager`- --------- --- ---- - - ---- -- ---- ------ - --- -- --
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Title of P$rtnetahip------- --------------'- ------------------ -----------------
Partner`s' Names P; C. Address
-`----- --- ----- -- -- ---- ----- ---- --- -- I~
' I1 . arm
or oartnereWp,: -
emm~ew. ---- ------ --- -------
space; otberwiae .. .....
leave iAblank --------
Manager- ---`- ----- ----- --- - ----- ---- ----- ---- - -- --
Names of OwneTS P. O. Addresses
p,~ ~,~~
---~1V~ __s~~~--- -- ---- ---- - --- ----- ------- -----
I[ neither _____________._
eomPeW~„
ell oue __________
space
Manager--------------- --`----------------
State names of Claims:
Patented -- -Unpatented
---
--- --- -- ------- --- ~r~
Total acreage patented___ __ ~ ________ _ _acrea; unpatented___ ~~______ __-- _acrea.
Do you own or lease these claims9___ ~a~~- -- ------ --- - ~` u
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If you lease em glue n me of company or person from whom leased- ~~?!- ~/
s~?
~~ c; - - ------ -- -- ~ ;
~~~/// (Over):
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