MINEBK00334

• County: Teller
• Document: Manager
• Suffix: A

~~03
MINE REPORT ;, ~ ;;
Noce-Please fill out this report carefully, write plainly and answer all questions fully. Be sure to
date the report and sign it. Fill out both sides of the sheet.
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3CREAU OF 11fINES, STA OF COLORADO.
T. R. Henahen, Commissioner of Mines,
Denver, Colorado.
Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows:
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s CE1'ELCF "'
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(Name of Company-The-----------------------
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~[ncorporated in the Stnte of________
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Principal office ___~?c~~~~_ %~<--~ ~C~ C,~C',~
--------------- ---------------------
I rtia ~ Capital stock ___ 3~ u o ~ u Shares, at ~/ ` u er share.
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c:: ~,t ~,,. Name
.,,,<.: o~e..w P. 0. Addresses
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President _/ 2N ~ ~ ~ - ,tiP. < c~ ~l - ----- ---- -
Secretary --- ~~-`-==~"f ~~__ it~ `2~y: ~~'.. ~. ~_ --- - - -
________ _..___Jl___________v__________
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~'I'reasurer ----~'-`-'='-~' =v--~Z--U~-~'-^-G.- =`-- ------«--- -----r------
// ----
~ lfaneger ___/.,,5?=u__~-, zf_-c_-..,,z_ c
Title of Partnership___________.__.__-_____
Partnrrn' ?':unrx ---- ----- Z'. O. Address
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f.'~~t tLb -"-- --- - -'---~ --- --
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~~n. n Wauk - __ _ ___
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~ilfanuger_-_.. __ _ _ __ ___._______
~ N:unes of Uwnera I'. O. Addresses
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t',n;l a~;rcage pnbrated-- -_._ _ _.. _. -. ncrea; uupa(en4ed- urrea
>>" Y,iu owa or lease these clai~anl__ . -- _.
if you Lase them give naair, of comfiuny or peraoa Yrow whom leuaed.~~ - - -_~~~ -- ~ ~ - . ~ -
(Over)
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