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/ ~! I <br />Character and valne of ore - --------- ----------- -------!~~"~~LC_~/~ -- <br />i <br /> <br />~~ Name ofmill(ifany),chnrnctorandenpacity_________________________________________•_____ <br />. , <br />~~ ------------ ~----------------------------- -~~0_' ---~-'L-~-.y~~-y-~--~------------ <br />~' Character of surface improvements _ _ _ _ _ _ ' _ _ <br />•- ~ -- <br />------- <br />- ----- - - =-------- - <br />Amount and character of under-ground development _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br />---------------- <br />----------------- <br />i <br />Signed-------------------- ~-------------- <br />- ------------- <br />~~ <br />