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Name of Mine____________ `~` ______ <br />Date of On(~t/jna~l~Loca~tQion ___________. ____. <br />Mining District __ _ ___ _ _ <br />Cou¢ty of . -- ---- --------------'--- <br />Title.- - -d -- - ---- ---- <br />vested in-------- - ----- ----- -- <br />148 <br />"r- ----'----'------------------ <br />St~at/e~ovf(~C~ol.,o~radov. - <br />__v~Q."-`^_~J`__ . ontaining_ /Q/`3-----Acres, <br />-~-~~!1!G-=-~"--------------------- ---- <br />Principal Office located at______I`~~ _ ~__'___!Q ' _ <br />____ <br />Branch Office at ____'--_______ ----- <br />---- - --- <br />----------------- <br />~j° ~ ~_~ <br />Name and Address Offic s_____`_'_!V___ _ --- ---- - - <br />-- ----------- <br />`w"~-K - - ~-- ---- ---- - <br />-- ---- ---- -- - - ----------- <br />-----~- <br />-------------'-- ~.-----'-------°---'-Strike ofVein_V.~,-~~r~l/.-!4/~_---__ <br />--~77/'---- - - -- _ <br />Course of Clai~~m^^._-__~.__`- -------------------~-7,~ - <br />__ v0 0 <br />Altitude at 'faro Workin s ___ ~-4=9--------- , <br />Character of Country Ro ~'~ 9`-~'`-'=s"-"-'-"---_°--"'-"~'--- - <br />Character of Vem____- v-~~~-------°°-'-Qw"-° ~ ~_~r <br />Character of Walls or Lnclosiug Rocks___ 4`_T-^='C`wt~`-=--------- <br />Character of Ore._'~-~•------------° °-- <br />Ore Otturrence ----°---- -----------------°--°------------ <br />Dcv putout, Venlilatiou, S• itnry Coudiliou, Idxils___________________________..________.____ <br />._ -__ _ <br />__ .___ _ <br />__________ <br />u.•~!•----~u -------- <br />------~- ---- - - .ti <br />!fi`''r.-'•2'~._. 75.~ --~ - - --- ~-- - <br />- -/l- ,/ - ;~--A-~. ~' <br />--•--- ~___°-------- 1 <br />~~ <br />ii. <br />q, <br />+~~~ <br />~i <br />j'' <br />I'~' <br />~~, <br />i!I I' <br />;,~ <br />it <br />!~ <br />~I <br />i <br />„~il <br />,, ~s <br />is <br />