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2io <br />.- <br />~1 <br />.._ <br />--------------- <br />\•^te of ]dine -- ------ ______ _ <br />a~• ~ <br />..nal ovation -------------"____- t---~ --~-- --'-~-----'-- jj <br />Datc of Ongt ___-_----- --~'~-~~'-- <br />- _ ---- <br />- -- <br />------ <br />..y -----~-=- --°~---- <br />V Location--___- ------------°--------------- <br />o ------------------ <br />---------------- <br />x O ---° ---__ <br />alining Dis ~ ___ ___________________ <br />%~ ~-- _____ _ __Stat of Colorado. Acres, <br />\ County of ------'- containi -- --- <br />----- <br />~ -- --'_- ..---'----- r <br />Title--------j/ -//-- ----------'--- '~___ <br />------° <br />D,9/l~_ ------ -- a----- <br />----------- _ <br />I'rincipa] O&rce Located at-----------------'------ ~- /f~f_ _ <br />-----'------ - -- - - ~jC-'/---'--'----------___ - <br />_ --'~i1 <br />- r -~ ,/ <br />--- <br />Branch Office at_ ~ - (I(Lt~d~Q~~___ <br />+:aiue and Address Officers-- ~~ _ ~~ ~~~1~` f/~/(~-e~/Y ar3C <br />___ - <br />----- -- <br />-------~------------------- ~:a-o ~----------------------------------------~/ <br />------ <br />Altitude at D4ain Workings-- _Sf~ -- "f j -- ~ ___________ _ _'--'-- <br />Character of Country Rock ~~~ <br />~xR'----- ------------ <br />_ ~~- <br />Charxcler of Vein _-____-_----'--'--- ----------------------°---- <br />____ <br />Character of Walls or Enclosing Rocks ---------------------"- -- - -___ <br />Character of Ore__ ~-~" / ----------- ---------°-"--`- <br />____-.- <br />----_- <br />Ure Occumence.____..-- ____________________ <br />_________________ t__._.. ---- ~t.~t..~t -Q O'- <br />Derelopnteut, Vevtilation, Savilary COIL ion, l:xits___.;~~, -__ _.._ <br />----- <br />_~j-c.~~°-------- ------ - -- - <br />--- ~--•- <br />I~ <br />~j <br />j!. <br />~I, <br />i <br />I~ <br />