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'/9/~j, <br /> <br />_- : ~-'•E'. Clear Creel - Daily. <br />~° MINE REPORT sz <br />Note-Please till out this report carefully, write p]ainly aad answer all gneationa fully, Be sure to <br />4 p>~ date the report and sign it. Fill out both sides of the sheet. <br />~bW D=_nv~r <br />---------------------------- Colorado Novemner loin, 191 <br />BUREAII OF bIINES, STATE OF COLORADO. <br />T. R. Aenahen, Commissioner of I<fines, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />Name oP Com an 5"°''~-dear ~r°~'•: '_'~1 [10e1 v? <br />P Y-Tke-- ===---- -- --- - <br />------ ---------=--------------------- <br />Incorporated in the Stnto of___ ~=~ r~= ~ ____________ <br />----------------------------- <br />Principal o83ce __~E~:y,;~ „~R;___________ <br />u.~m Capital etoek _~.rria"_~iv--------------Shores, nt $__1.~r.-__-- Per share. <br />en oae <br />,P,... ,rs..r.. Noma P. 0. Addresses <br />letn ie blurt .,O DCert CG7ti: ~- ;~G~., •~ <br />President ''G°'~='~ =' '• <br />--------------------------------------- ----------------------------- <br />Secretary _~._3.:'_2__3,iJ; ;.*_____________________ ___y~1L":3,J__J~R3~3.________ <br />Treasurer t~bert Jcoct ha:n°J :lanaws. <br />_ <br />------- <br />Mana er ~ ar.^Jc r.. _ _-~L !.,. IT';, 1;x10. <br />g ---------------- ---------------' r <br />n .arm <br />w w+rna.lla. <br />an unl ew. <br />N.t.: ot6mrlw <br />lens 1t bl.nt <br />Ir oellho <br />mmryur oDr <br />p.nnenYlpp, <br />all oat tiW <br />ry.n1 <br />'Title of Partnerahip-------------------------- <br />Partners' Nnmca <br />-------------------------------------------- <br />-------------------------------------------- <br />-------------------------------------------- <br />-------------------------------------------- <br />:lfanager------------------------------------ <br />Names of Owners <br />-------------------------------------------- <br />____________________________________________ <br />____________________________________________ <br />State acmes of claims: <br />------------------------------------ <br />P. O. Address <br />--------------------------------- <br />--------------------------------- <br />--------------------------------- <br />--------------------------------- <br />--------------------------------- <br />P. 0. Addresses <br />--------------------------------- <br />--------------------------------- <br />_________________________________ <br />Patented Unpatented <br />,. ~ ,. <br />.:u ~'~... .. ,,.,. <br />.. ~__:~ <br />~. , ~. ... <br />_________________________ _ ___..__J ..-....._____________-_________-_____ <br />___________ <br />~ilpon ~'i ::.:. <br />Tot acres a ___ acres; nnpatented______1;.~_________________acres. <br />g Patented____ ~^.______ <br />r'--' ------- <br />Jo on own u: lease these claimat____ ~=---~--=~-~--~.C9!'zc~~~~-~--`•-~' -./r-"~C-~ '~r~~~~~,/ <br />Ii y^u lease them give name of company ar person from whom leasedfFlc~~~f:Y~"!r"~`= <br />(Over) <br />~I <br />1 <br />