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<br />~.~ ~ 1~llINE I-DEPORT 5
<br />'`~ _
<br />e as date roPoK•- to Cem Pant or 9rou p.
<br />^ s' naTe oT eaoh elalm belonpinp
<br />~( In oareru llY-MEN EMPLOYED.
<br />eut blank en oPPOelts altle antl elpn report.
<br />ohine ehopa, ~-~ .....................~................._.. Colo., ..~i~ «. !.......__..199'
<br />BUREAU OF MINES, STATE OF COLORADO,
<br />_. T. J. DaT.zeLT,, Commissioner of llfiltes,
<br />DsNVSa, Col.oaeno.
<br /> ~u°rc~
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<br />Location
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<br /> .......
<br />~..c~.a.c.<_c.c.- County ..............._............................._.......
<br />Mining Diatriet ................................................................................................._ ................
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<br />ddress
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<br />a
<br />Owner or owners an
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<br /> ......... /~ ~n
<br />.».______..._.__ Namo of Company ......._ ........................... `
<br />(IY 1NCORPURATNP)
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<br />per 811arc.
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<br />Capital Stock ""' "' (
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<br /> la pl'Oparty wal'1{Cd CCntI11UCIlNIyt .................^....................... 19~.........
<br /> ................
<br />..,.._ Uomrnonoe(1 work .......................». ........ 100..».....
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<br />..~_».~... Stoppod work ...................................».....
<br /> MEN 1:MPT+UYI.D,
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