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29~ <br />F~.'yI <br />h~Uy <br />/J <br />Name andyA,ddretss Officers._~] `~!A.cA -~/Yy~l~py_r!~~{__~,~_^_1~--------------------- <br />~-y ,,q ----- y c.l.t--~ <br />r .~_~y/,I I_~r, et _/_l.___'f.-~r_~$-K ~)_~!=~-sL ~F11 ~--_-_~_~~"Li ~j_1/ ~____-'____ <br />~ 1 .. !at. ,.. ~~ F. i ~.~,. 1'n (~ ~,.ie A_ ~~h!,Xly~__~_ vll_~}1tilf~i_`L;__i ~l/ <br />~• <br />Nam of Mine= 1.- ~ - <br />~% V:j- <br />` Date of Ongmal Location ____!~-rL~:.L~na.~_____. _- -----------'--- -c--------° <br />---` - <br />~.. ~ - <br />((~~ l ,1 r <br />Mrning Dtstnct _. N ~!!'Ld:.~1.~r-=---~------------------------- ------------ <br />Count of L~.CEa n ~ ,___St~ate o~ C - <br />~ i ~• <br />Trtle.----"_--- • , ti~ - containtng-_--'---------Acres, <br />vested in_ ~' ~----)-=tJ ~----~~'_/~!--'~~,-- J'!~ -------------'--'-----'----------'- <br />\ ~~tt p i <br />Principal Office located at_l~!~'!~_/t1~_iQ_ t~?__ ~t_S!)!U~6~1--1~=~1-~- l~~'k='?-~'1t/'- <br />~: - ll ! <br />Branch OSce at _-- ------'- ------"`----------° ---------- <br />::-~yy~~---~:~-ult;v_rfa~ .T~/.ys.kvl,__.~~f~G.~[./~C.y,nn.t:--~-`-`.=l"---------- <br />------ 1 <br />_ ~ ~---------`f==-----=----------- <br />I ~ ~ =-,- <br />Course of~Cl~i~! ``~``GRy~^=."~"""`1" <~-_~_~ ~~i1Ce of Ve`;t~._• ,'~'~rSv -----'------'-- <br />Dip of Vein _---_V_°_/_\S1/D..~~~.~ ~ ~__~- \ ~Y-' ~ ==-? ~---=-'-------'-°---------- <br />`` .~ r <br />Altitude at Main Workin ~S-'= }^"- ~'t"~' ~"--~°-----~--~---~ <br />Character of Country Rock __.L.o1 i~-f~='~ ~ ~-~-~'~~-~--'=L~~~~'"---"-'--°"---------- <br />t - <br />f % , <br />Charaeter of Vein__~ ~.:' ~-= --------------°--- <br />Character of Rtalls or Enclosing Rocks._ ~-' <br />Character of Ore.------'---=-.__'_s. .__r<'---- h'~-- <br />---1 -----_"_ 1i <br />--°---- _ <br />Ure Oceurreuce .~ `=1-'k 't~~-dA"~D--'--"""""---- <br />___ ___ ____ ~_ ?J <br />' , f <br />------------ r-~- ,. ~ ~ , <br />---- <br />------~ , <br />--------- ------------- - r,t, :_ -- <br />Dgve~pmeat, Veuttlggou, Su Lary Cond~'ml, }s' t ~ [° r~ / <br />~ ~ <br />~-----' -. fit; t~ ~ ~ ii c ;,~,,,~~, ~ ~ <br />__-__ ~ . <br />_ _ _ _ __ <br />_ V __ __ r~i. _:. dal .__•_!~ :J--'_ I_-_ U_ <br />_ ,~ ~ r <br />_.. - <br />.r_____ <br />l~ _ - -- <br />-!~~_x_-rt~c .-o .n 1 _V ... e .. V.....)1 )l, Sr.eL+h__ Vt..4vio..~------- <br /> <br />-~'-- <br />--- - - _ <br />,2-_1za~ ~d~Ju.._ <br />~- -- <br />