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f <br />.). !) ~. <br />MINE REPORT ~ <br />Note-Please 8ll out this report carefully, write plainly and answer all questions fully. Be sure to <br />date the report and sign it. Fill out both sides of the sheet. y^} <br />-__~~L-----_-__---. Colorado, ---fi~!cQL- _ a_~ ~_~ 19~aQ <br />[iOHI:A17 OI' iIfINES, STATE OF COLORADO. <br />T. R. Hennhen, Commissioner of Mines, <br />Denver, Colorado. <br />Sir: In accordance with Scetion 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />Nnmo of Company-Tlte__ _ _ _____ ________ __ <br />i <br />Incorporated in the State of________________ •" ' <br />Principal office -------------------------- ----------- -------------'------------.. <br />Capita] stock _____________________._._._Shares, at ~____________ per share. <br />u . artnP.nr' P. 0. Addresses <br />all our . I. Nnmc <br />qnm; arherwlw <br />Ia~T It nlsnk <br />President --------------------------------------- ----------------------- ---- <br />Secretary --------------------------- ----------- ----------------- <br />ar .nun <br />. o.nnn..mv~ <br />All our lhl. <br />q~.oe: alinrsl.e <br />4o~~r II Llmk <br />'treasurer -------------------------------------- ----------------------------- <br />Mnnnger ------ ----------------------------- <br />-------------------------------- <br />Title of Partnership__ ~~ ~~!t^"-~~- ' ' r <br />Pnrtnrrs' NI n•s <br />P~. n_ <br />(,c,~.;~.~,~•2 <br />Y ~~~~ --------------- <br />~-1~,~' - <br />___-J_I l.'_-Y J_1L_. - __ ~ ___________ <br />ff_J _ <br />lpfnnn ~r __.L~L_G_ ~ n `~ <br />g' - -----1-t----------- -- <br />~ Names of Owners <br />I....-- --------- -------------------...-- <br />n^I' T nor <br />larti,.rnnl <br />nn nnr ws, ~ ___________________________________________ <br />9ace <br />~lfnnagcr --'--------------------~ -----~ ---- <br />~Inlc names of claims: <br />Y. 0 •~ddresa <br />---.. <br />---Q~ ~~-~--- <br />r <br />___ _ _ //--~~ /J <br />P. 0. Addresses <br />Patented ~~ Unpntented ~?'~~ <br />---- ---------------------------------------- --------------------------------- <br />---- -- - ----- - <br />-- ----- <br />'falal acraa c _-- __ -. mores. <br />g patsated____________________-----arres• un mtented__~ -- <br />Do 5'ou own or lease these clnimsS-------------- ----°--"-"-----~~--- <br />If pnu lease them give name of company or person from whmn lensed______________---- ------------- <br />- - <br />-- ----------- <br />(Over) <br />