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the leasing com. <br />ddress <br />-------------- <br />--~ <br />r_ __ _hour shift. <br />r____hour shift. <br />r____llourslli[t. <br />r__ __hour shift. <br />r____llour shift. <br />r____hour s!IiR. <br />r____hour shift. <br />r____)wur shift. <br />r____hour shift. <br />r____hour shift. <br />r____hOnr 6111ft. <br />g_ ~____ <br />orkmen in the <br />MINE REPORT ' , i r., <br />Note-Please flll out this report carefully, write plainly and answer all questions fully. Be sure to <br />date the report and sign it. Fill out both sides of the sheet. <br />- - ---------------------------, Colorndot -------------------------~ 19--- <br />BURF.AU OF bIINES, STATE OF COLORADO. <br />T. R. Henahen, Commissioner of Mines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follo~va: <br />Name of Company-The--------~_____ ____"__'---_-_~_~.!/~~__ _ ' <br />Incorporated in the Stnto of________~`-~- ~``--~"-°------------------- <br />Principal ofHc ~~1!°-~~=~~=~=~ -~ ----- r~ <br />,~-J~ ---~--------------------------• <br />Capital ~tock~~~ `=!"ter""`-`-'"~llnres, nt :(;_F~_?z ~-=.- Per share. <br />It • Comp~nr. ' <br />en ant t 1. a P. O. Address ., <br />s,.r<: otnR.w ~~,~ G4 , <br />Irvvr It blavk 7 py~ (~ r 21 - <br />Prceident ~.i??: ~__«. sly 3 --- ~ ---- -- <br />Secretary'~ -- -- ~ p/p~ r----- -- l <br />~• nn .ACC ~,cc,,Cc ~ - <br />Treasurer ------z,C~-_f._5~~~ ,,.AS_~2_Kti ;c~r_G_1_!_-~ ~-~-~'=1-~ <br />4 t t ( t <br />;1lnnnger -------------------------;-- <br />It .arm <br />nr Dvrtnenhlp, <br />011 au[ th6 <br />gnrr: o[hrrw6v <br />Inr. It blwk <br />Pitle of Pnrtnershi ---- <br />p---------------------------------------------------------- <br />Partncrs' Names P. 0. Address <br />L~IOnllgCl'____________.- __________________..__._____._____ <br />Names of Owners <br />a ndtber <br />nnpvn7 nor <br />yertnrnhly~ <br />..".II nut IiWL <br />.yore <br />~% <br />_______________ <br />SIIlIILLCt'r__________________________..____. ____ <br />P. 0. Addressee <br />--- - <br />~, <br />Rlutc names of claims: _ <br />~ (~.~~~t , ~ ! t A llnpalentetl ~p <br />_ ______ <br />__. _ <br />~ ~ i <br />~ / ;__ ~~L ~ _-_ <br />- - - ~~ ~ <br />f- - --------- -- <br />_~ %~-z.. - - ----- <br />---------------•-------- O --------- <br />---------------------------------------------- <br />_ ___ __1lCCL'S. <br />'fotal acreage putented_~=-°-~'-~==~~-- nrres; unputentedr -- ------ <br />_-- ,~ f~~..~_~ <br />Do you own or lease these claimst_ ~,t.~-•--------------- <br />--~ --- <br />--------------- <br />1f you lease them give nume of company or person Yrom whom lensed__-_ `~-------- <br />---------- <br />----- <br />-- ----------------------------- Over) <br />