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~ J _ v <br />~~ <br />/ty't ~t' ` ` y' ,-i a ~~ -~' :~ <br />MINE REPORT ~' <br />Note-Please Sll out Ithis~ out hot sidesoftthe she t~d mower su 4neations folly. Be sere to <br />date the report and sign /-~~y^O <br />~~r1~~~.!/~`_!~_.~'p_?r~Colorado, __ `' - /L~-~~-, 19~~. <br />BCiiF.Ali OF DIINES, STATE OF COLORADO. <br />T. R. Henahen, Commissioner of clines, <br />Denver, Colorado. <br />Sir: In accordance with Seetion 4299, Revised Statutes, Colorado, 1908, I submit report as follows: Lved~ <br />If n Gomy~nT <br />611 ou1t b <br />ry.rc: aWemrw <br />Im•~ It blink <br />u! .Ann <br />~r tonn~nhlD. <br />All mLL edr <br />rover: atl¢rwlu <br />~~ m+ IL LLnk <br />.• n.nb.r <br />ui'~rnl nor <br />ant irrnhlp~ <br />^II uut Wb <br />=puv <br />Vame of Company-The__________________ <br />[ncorPoratedZn the State bf_____________- <br />------- <br />Principal o ce -------------------------------------- <br />Capital stock --------------------- -- --Shares, at $___----__--- Per shore. <br />Name P. O. Addresses <br />President ---------------------- ------------- <br />-------------- <br />--- ----- <br />Secret¢ry ----------------------~- <br />----------- <br />---- <br />Treasurer --------~ ---- <br />---------------- <br />Manager _. ______1~_=t~.________ _~_~t________ <br />(Title of Partnerehip__ /- ;~ p, O~ress _ _.----~- <br />Partncrs' \umes <br />., <br />---- --. ~ _ Z~~-U ~l <br />_ ~/~~/ LLLII'- _ ~.s <br />~lDfunugcr__ __ ---------------- <br />1 (~ P. 0. Addresses <br />~ Nnmaffof Owners \,r <br /><.t- _ __ _ <br />-~~ ---=-t- .~_ _ <br />_._-_- <br />._____._ <br />Atunager _ _ _ _- -' " - <br />:ante names of claims: <br />Patented <br />~ ------ <br />I?nputented <br />n <br />__-- <br />L <br />ze <br />,TOhll <br />oY ~ <br />r, <br />ne <br />~e <br />c <br />~ ~ <br />--------- -- ~ ~j,C~'~y,.. _ acres. <br />'1'uull ucrenge patented-------------------------sores; unpatented- - <br />- ------ <br />y/~lwll= ~ ~ ---------------- <br />llo you own or lease these claimnt___.lil(: G---4~"~-•`f"~ <br />---- - <br />lf you lease them give name of company or pereon from whom lesaed-------- -----"-"-: _- - - - <br />---- <br />-- ------------------------- <br />--(Over) <br />