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- Sir: I he~by submit re rt as.fo ows ~ !~ I // ,: ~ ~ _ <br />Name of claim-- !~_~_____ _ '~J/6~ ~/ _ <br />------ ----- =------ PtiG~C~~p~Ltlq-- ~-- <br />'r ____` <br />Location ~ -- 1='-`-0--=-~~~"-rr=`~a~„--- -'-=-------- ------------ ---------- <br />Miaiag district~©~dl'4---------------- County----- --- -----'----- ---------- <br />--- _ <br />Course of claim .----------------------------Course of vein--_--------------------_---. <br />Dip of vein-----------------------°--°--- <br />Is claim atentedl . _____ _ <br />p - ~ - - ---No. acres ---------------•---------------- <br />Character of ore- - .__.____ _____ __ __ ' <br />Grade of ore__ ~~.-------------------------------------•- <br />Is claim working? ___ __No. of mea employed__4__________________ <br />--- - ------ - <br />Willclaim be operated i~r? --- ~-- -=----°------------------------------------- <br />Gross tonnage shipped to smelters.lS~tP/_~~_Gross toanage milled----------------- <br />Ch~~a/Jracterofs~/n//rf~~ace/' provements_______________________ _J'_____ _____________-_- <br />and character of dsvelopment___ ____ <br />2.~ <br />!~ ~ ~~~s~~ _c1ES~ <br /> <br />--------- ------- ----------------- <br />yYl __= ~G'~'+EPiI~__SiG~- <br />--- <br />------------------------------ ---- <br />Owner or owner and sddreaa. (Jf incorporated, amoaat <br />~ same and addrear of preaideat, secrebry and taperia <br />~r ~„ ~ o <br />~~ <br />~~- ~~y y <br />stack, anmber of share,, <br />/.3.~e~eu------------- <br />Si~oed~-~: ~ ..............:T~ ..__. <br />cil ~ketcb oo-6+ck rof t6~is «por~t, t~bs~lowt o~~d~erel~op~rm~enef.~url~c ~ritb nk ncbe w.fd .mad <br />eod line. <br />