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~'JI~ <br />j i If yon have given n lease to othere.for all or pant: of- the property,: state the names of the leasing aom- <br />"i parries, partnerships or individuals: <br />' Name Marra er P. O, Address <br />i <br />I ~ '-----'-----------° ---'------ ---------------g ------------ -'--------------'----------'-' <br />G'IIi ----------------------------- ------------------------------ ------------------------------ <br />I, Is property worked contiauouslyt__________________ __ _~_,,( _____________________________ <br />II ~ IP work has been stopped, state when_~ _ ___ 1~~" __~~ ~ ~________ ______________, <br />I ~~..oo /~ J <br />~ I Nnme, title and address of person in charge of tiG~r you__J_~,recrr~'r ~N -~ ¢?~~ ~t!d <br />II~ ------------------------'--------- ----------•----------------------------------------------- <br />ti ~II State the character of ore__ ~m4>__,~tt~9-w___~?~1/____________________ _'"-~7~ ____-- <br />1r 1' State the value of the ore____1~aa~rc• ___~ _a~y_~!4! _~~a7t~__r ~~,.___, <br />If''!,I ~ MEN EMPLOYED <br />f: No. Employed No. Employed ~w <br />. ~_itfnchine Drillmea, $~?~for__~hourahift. __(__Engincers, _ _ _t$_~~d~r_~'_honrshift <br />I ~ -~_binchine Helpers, $ ,~for!e_hourshift. _____Pumpmea, _ _ $______for____hourahift. <br />_____Dfiners, _ _ _ $______for____hourehift. _____Firemen, _ _ _ $_______for____hoarehift. <br />i <br />1, ___ _Timbermen, _ _ $______for____hourehift. _____131nekemithe, _ _ $______for____hourshift. <br />' !' _.Z,._Trnmmers, _ _ _ $~for_-,~'_hourshift. _____Teamstcrs _ _ $______for____hourshift. <br />'~~ _____Cre Sorters, _ _ $______for____hourahift. _____Foremen, r <br />~~~' _ $______[or____hourehift. <br />' _____Topmcrr, _ _ _ $______for____hourshift. __~_Superintondeat, _ $J.~t3-~or_~-hourahift. <br />I <br />' _____Lnborera, _ _ _ $______for____hourehift. _____Cfnce Help, _ ffi______for____hourehift. <br />,I ~ ___Aaenyera, _ _ $______for____hourehift. _____lliillmen <br />~'~j -- - - - $---___for____hourshift. <br />~~~ ~ ~ _____Electricians, _ _ $______for____hour•ehift. -____~Vatchmen, _ $______for____hourehift. <br />ll` ---------------- - - $------for----hourahift. ---------------- - $------for----houtehifk <br />i // - <br />I Average number of men employed this yenr____(O___________ <br />I --------------~----------- <br />----------- <br />Is there a milli--.sd~0------------------------------------------------------------------------- <br />Nnme of mill-----------------------------------Lacntion of mill--------------------------------- <br />Charneter of mill_____________________ <br />I ___________ <br />I I" ____________________ <br />____ <br />(. 'I a ____________________ <br />4 Capacity of mill---------------------------------~Vhen was mill erected---------------------__---- <br />,; give list oP buildings, tramways and other surface improvements -lm~%~.Y~q.6y~ Jr4uett[_{'~DJ:~s'O <br />_ ~o~e..,~t~ ~~n..,..rt1----------- ---- <br />-------- <br />"' Coat o4 surface improvcmente made in 19111 cvt_0-••~ti <br />~ Stato amount and character of underground development: <br />i ~ I. Total Development Amannt Done is 191t~ <br />Shafts -----------------------------ft. <br />j ____________fk; cost per ft., $__________ <br />(; i ~ Winzcs ---- -----------------------ft. ft.; coat per fk, $ <br />~ Drifts __ _______ ______ ft, __~ _Q_0 ft.; coat per ft. s j0 <br />- --- <br />~' Crosscuts ~~.~ -- --------------ft. --~-~----ft.; coat per f- ti~g Qy_z Y -- <br />li '; f $ave you reported to this department all 4atn1 and son-fatal accidents ocanrriag to w rkmen in the <br />4 ~j,' twelve months preceding the date of this report, as regnired by lawt _~/~ <br />~'~~~ Remarks:---------------------------- ~- -°~r'4'~~f1-- <br />---------------------------------------------------------- <br />~~l - <br />Signed_---- <br />--r-----r-~V4F~-47f: <br />sF-~~``"`~ ---------- <br />T;tle _ <br />---- --- <br />