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~01_'> 6 <br />16 Name of Mine__C__~ <br />Date of Original locat~io/n :_ <br />Location _.(f~L.___~G~ <br />Mining Dist~ri/cJt.__~ iti <br />County of.:17I11~_ __, <br />Title::~OffGjj!,,//Lt~sc~-°jjJJ''_~~_ <br />vested in.,t,!Jl4__.~L~J~C <br />Principal Office located at <br />Branch Office at________ <br />Name and Address Officer <br />r <br />~'~.~~--~ ------' <br />--"- <br />'°'''----- <br /> ~ <br />r <br />of Colorado. <br />-_. cot~taini t~g _`~_~~ r <br />-- <br />- _~:-:. <br />----- <br />-~ - - <br />_.. <br />~ --- - <br /> <br />------------------- <br />Cottrseof Claim. ________ _ ______________ __Strike of Veiu_ ~~_q~ _ <br />Dip of Veiu_ _ ______________ <br />Altitude at Main Workings ___ _,,~ _O_-.~/_ _ <br />Character"of Courytry.R ck,_ <br />Character of Vein_ _ _ _ _1_____ ~~ <br />Character of Walls or Enclosing Rocks._ 1_i _ _ __~L __,~~~~-_°-------- <br />Characy~/te~~r o~~~~f "Or"e _ ~~ _ __/_~~~t'yµy _.e~ia.~~,~_-d~.evf <br />'~~~jrvT~'~' ~-' - -`-----`--t~----'------ -r------°----------- <br />JJ ~ --------° <br />OreOQcc~urr~ence ~.~'SLp___~ _-t.A__--`"~__L~`__ ~~-~-:.,~ <br />~Rll..7Y.c„`~_`'_'1`L'`4GS~4--~F/!~u---' - -`A~'~ics~r'~~---•-"~-C3'-`~°r~--- <br />Ventilation, Sat tary Condition, <br />T- n . r _. <br />-------~'~-------------q------------- ------- <br />60 <br />~~ <br />--- <br />~~ <br />__ <br />s' <br />~~~. <br />