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7 ,~ it ~~'~i l ~1 If ~, '~ i ~' ~ fl ,, r. I ~ ! t I ~_.:. ~~ ;.~ f' ~ ;,~. i If you Gave given n lear_ to othm for aD or part of the Property, atatc the unman of the leacng eom- ,P/a>/~, palrt`nerahipa or iadisidnahc: /~" ~ ,~ . / (~ n~ . Addrear J'~tu+%~~S~tj --- ------------------- --------- -- - ----- r ~--, (-' ~ ------- -- -- ~-- -- ------ r----- J_ _____ ___ ______________ _i"--' U' L ~ _ _________________________ property worked continnoan]yl-----------<%-`Q/--------------------------------------- If wort has been atopped,aate whea_______~ `tame, title and address of person in e a ~f or ~r yVU' ----------- ------------------------ Stay. the character of ore___--_ v~~'~"'~ / ----------------------------------- _ , ~~ ------- -- - --- --------------------------------------------- Stato the value of the ore--_-----_ J~_~ ~`'_--`_"`- ------------------------------------------- S!E_ti E]1PLOYED ~o. Employed \o. Emoloced ____3fachiae Drillmoa, ¢______for____honrshift _____Engineers, _ _ _ g______for____honrahift ____Jlachin>_ Helpers, g______for____honrahift. _____Pampmen, _ _ g______for honrahift _~Q ]finera So ~j g~_- f 0 ____ . _ , _ _ _ _ or_ __honrshift -----Firemen, _ _ _ g______!or____honrahift _____Timbermen, _ _ g______for____honrahift _____Blacksmithn, _ _ g______for____honrshift --_-_Trammers, _ _ _ g______for____honrshift -----Teamsters, _ _ _ g____--for--_-hoar:hitt _____Ore Sorters, _ _ g______for____hourahift. _____Foremea, _ $______for____honrahift _____Topmen, _ _ _ g______for____honrshift. _____Saperinteadeat, _ E______for____hoarshift _____Laborm, _ _ _ g______for____honrshift. _____Ofrice Help, _ _ g______for____honrahift -----='.swayers, _ _ _ $______for____honrshift _____]fillmea, _ $______for____hourahift _____P.lectriciaas, _ _ $______for____honr-shift. _____R'atchmea, _ g______for____honrshift ----- _ _ g______far____honrshitt. - ____ _ g______for____honrshift. Average number of men employed this year______"~'~_ /~________ - ------- Ia there a mill!______ ~-~_ - ---------------- - -------- ----------------- Name of mill---------- ------- ----- ------- --------------- Location of mill_------- ---------------- -------- ---_------ aracter of mill_______ ----- ___________________ - -------__-- ---- ------ Capaeity of mill-------- --------------------- --- ------------------------ ------------------------ -~, en wan mill erected--- ---------------------- ---------- Gice list of buildings, tramways and other surface improvements __________ ----------__-- __ ----------------- ----- ______________________________________ _______________________________________ __-___ at of aarface improvements made is 191___ _ State amount and character of andergronnd development: Total Development Amount Done in 1913 Shafts -----"-~c'~--------------------ft. ------------ft•coat er ft S r P .$---------- ~Viazea -----~---------------------ft. ------------ft.;coat erft P .8---------- Drifta -----_~QQ ~ ---------------ft. ______----__ft.; coat er ft P .g---------- Croascuts --------------------------ft. ------------ft; coat per ft, E---------- $ave you reported to this department all fatal and non-fatal accidents occurring to workmen in tha twelve months preceding the date of this report, as required by lawf _________ ----------------------- marks:- ---------------- ------------------------ --------------------------- --------------- ------ -------------------------- G~~~ -------- ------------------------------------------------------ i ~ ,F -~ ~~~~; Signed--