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~ ~ 02 <br />em- MINE REPORT <br />Note-Please fill out this report carefully, write plainly and answer all gneattona folly. Be sure to <br />date the report and sign it. FiII out both aides of the sheet. <br />---------------------------------+ Colorado, -{-----------------------,19--- <br />BUREAU OF MINES, STATE OF COLORADO. <br />T. R. lienahea, Cammieaioner of Dlines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revise Statutes, Colorado, 1908, I submit report ae follows: <br />Name of Company-The----- ---------- --(~-~----------------------------- <br />Incorpornted in the State of------------------------------------------------------ <br />Principal of8ce -----------------------------------------------------------------~ <br />Capital stock ___________________________ Shares, at $____________ Per shore. <br />n . Com vvr, <br />en m,t tgl. Name P. O. Addresses <br />rpett: othenrW <br />lease It blunt <br />Ir . Erm <br />ar wrtnmblp, <br />CII out th6 <br />ryvne; otbenrly. <br />lens It bbmk <br />If neither <br />mmwv7 vm <br />Ol rtavm~ <br />ePen <br />President --------------------------------------- <br />Secretary --------------------------------------- <br />Treasurer -------------------------------------- <br />Dfanager --------------------------------------- <br />Title of Pnrtnerehip-------------------------------------------------------------- <br />Partnrrs' ~nntes P. O. Address <br />-------------------------------------------- --------------------------------- <br />-------------------------------------------- --------------------------------- <br />Sinnnger------------------------------------ --------------------------------- <br />Names o4 Owners P. 0. Addresses <br />- -- <br />----- Q _ ... ---- /~~~ <br />~~ Q e~1~ <br />--~!'~ z------------------- <br />------------------------ -------------------- <br />'~7~~~/ ''y~/I_~,/ //,, ____ <br />11[anager _-yY~~---~ ~_/_~C.l~_L! ------ --------------------------------- <br />State names of claims: <br />/ //~ G~ Patented Unpatented , <br />'----------J1----------- ~y-_ L <br />---------------------------------------------- --------------------- <br />--------------------------------------------- -------------------- <br />Total acreage patented___1__ jLSL--------------acres; unpatented__-______------------------acres <br />------------------ <br />Do yon own or lease these o]aimeT______8_-!~=LC------------------------------ <br />If you lease them give name of company or person Prom wllom leaaed-------------------------------- <br />-------------------------------------------------------------------- <br />(Over) <br /> <br />