MINEBK00334

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

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MINE REPORT ~~~, ~ :,.;,,
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Nate-Please 8ll 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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--------------L---. Colorado -----'-------. 19/f
BCP.F.9li OF DIINES, STATE OF COLORADO.
T. R. lienaben, Commissioner of \Iinea, ,
Denver, Colorado.
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Sir: In accordance with Section 4299, Rewi/sedStatutes, Colorado, 1908, I submit reporpt.as follows:
(4'ame of Company-The----P-_`~'_'~~----~iLl~`~..-t.`>---1"_---------
jineorporated in the State of____L~ v'"'L`'`"'J _
j Principal office --- E~ _'-/~'_ ~
~/ -----------------------
(Capital stock _C__o_'!_o __a o a _ Shores, at~ ~~.,G~rper share.
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IPresrdent -- - ---------------------- - ----- -- - '-
------------------
~Secretary --~/-..---------------- - ------- --------------~1-------.
(Treasurer ----- ~ - -------- ------ ---------- ..
~ - --
---- -------------------
'Dfanager - -~-- ------------------------ --------------~~-----------
(Title of Partnership----------.-----.-----.-_.__---
I Partners' \:unt•s P. 0. Aaaresx
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uut fhb ._ ___. ..___. ____ ____....____. _
yvr; V•.LfrNw
Inr. a W~uk
I .. _ __.. _..-_ ____ _ __ _ ___ _ _.___
~ Nnrnes of Owners
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I'. 0. Addresxex
-- -- --
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. _._ ,5funugcr.. -. __. _ - - -
----- `i:rrr n:uuen of claims:
-- -- I'ntented Cupnlrnled
.en in the ~~ ~ ~~~
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~u~~ Y' - -r/-~ - --
'------- 71,ta! ar:reuge pntenlca_.._ ~ -- _ _-- - -ncred; unpulrenled_.
.ompany. Do yuu own or lease these clai'msYi__ .V'~ "` -
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---- - 1f you louse them give name of wrnpuny or parson from whom h:nsua_. ... -
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acres.
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