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20'7 <br />Name of Tline--_-'--'- ---' -'------ '-------- ------------- <br />•-- <br />---° - <br />Date of Urigwal iocati _____ _ - - ~ <br />~~f}~~ C_XJj_ r <br />,/~ ,, /, ~ <br />--- - <br />loration ---------- ----- <br />----_ - <br />Mining District. ------ _n <br />___ State of Colorado. C,ce.cu.< <br />County of.- - -_--- ~ S~ _, containing 1t~-~-'~=~`-----Acres, <br />f~=~ i ~ ----- -- <br />.•ested rn __________ ________ ___ _ ________ <br />J <br />Principal Office ]ocatea ac--------------- U v ___---- <br />--__.. <br />~- - - Branch Office a[ -------------'-- Tl~/?_!'~~-°-'------ I <br />'-'t- -- -"----_"__ <br />Nam4ean~d~A,d~dress Officers----- ~•- <br />-- ----- <br />------ - <br />Course of Claim.___-=-st__S~_-v- ----~---------5[rike of Vein------------------------'--- <br />Dip of Vein ._----'------------ -----' <br />Q -~-~ --- ---'-'----------------^----°--- ' -.. <br />_ - <br />Altitude at Dtain Workings -- - "_:"`= `' =Gr/~~^~ ~ '~ <br />___.._ ~- 1 ~ ~ <br />Character of Country Rock -----~~ ---------- ~ • <br />-•------ -------•---------------------°---- ~~~ If . <br />Character of Vein------------- ~~ -__-________ _ _ <br />Character of Walls or Enclosing Rocks.__'s~"= _--"'---~- ~ <br />--- -------- -----------::_-:___:_--:_-_ --___:_--_--:__-__----_ ;~~ ~ I <br />---- <br />Character oC Ore.___._-.._ ----'---"--__------°--' N .., <br />~-----'---- ---__ °' f~ <br />----------------------- --- ------------~---------------------------------- ------------- 4.~i~~~. <br />----- ~ it <br />------- <br />Ure Occurrence ------• <br />Development, Ventilation, Smtitary Condition, hxtls-___-°--------'-------------------------- ~ <br />_ ----------••---------•----- -•--------------•------- I'~ <br />---------•-------•°---•---•----- II~111, <br />----------- ----- -~•--°----------------° ---••---•---°------ --•------- •------------- - ~,il <br />--.....__--------------°---------------- _..------ ~~I <br />---°-• ------------ ' r <br />------•- ._...------- 1 <br />--°- <br />-------- <br />~, ------ <br />