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L <br />~\ ~ i -~ <br />%I'V/+/ 1 <br />MINE REPORT ~~t11 1 <br />Note-Please fill ont this report catefnlly, turtle plainly and answer all questions fully. Be sure to <br />dsk the report and sign it. Fill ont both sides of the sheet. <br />BL'RF.ati OF bfI1~'ES, STATE OF COLOR_1D0. <br />T. P.. Henahea, Commissioner of Mines, <br />Den~•er, Colorado. <br />Sir: In accordance with Section 4~99,,,Re/cisedStn~~fcis, Colorado, ]905,,~I snh~m/i1t report ns follo~cs: <br />(A'ame of Company-The__ ~!_~~!_ ~!!!-~C~"_!~_C_____r_/____!_!i__~_ ~____ _, <br />Incorporated in the State of__- _ _ <br />I ff ~.n_ <br />Principal of5ce~j~_Co._- _!a~c.a_Q•earer d ~17~0- <br />I~ _ __--_. ___ . <br />- t- <br />e <br />n ~ CamP~^l. i Cnpltel stock ~~ ~4_Q ~-O-Q-- - - - - chnres, ut $. --~---- <br />~- -------_ per shnre. -- <br />eu w[ ml. _ Aame P 0. addresses <br />rpiK; O:btKrl~t • - <br />Fm It bl~ok <br />t <br />President !~.-1 ~~_'"`'~!'c -- -- --. - - ~D___ a - <br />-- --- - <br />Secretary -w-_ .----- ~---- - - ~ rf r~ <br />Treasurer ---~~ ----------~~--- - ---- - rt ry ry <br />Manager ~ ------- `- - ----- - ---- ~-'~~ ~- v~-~/ _ 1t <br />('Pitle of Pnrtnernhip_________ <br />Pnrtncre' Names <br />I'. 0.:lddress _ _ <br />u . aK~ I <br />or Imnmhlp, i <br />A I: a u: t L I r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ <br />rPrre mL.r.iwe <br />len.~ 11 Lluit <br />11:mugcr_.-----. --- <br />Humes of Owucra <br />vmNnJ uur <br />~.un~,..ddp. <br />:Il uut^un '~ -- -----~ - -- <br />•4rK <br />I ____-. --. --... __. _ .._ _ <br />titunugcr . <br />~::~1~. w: nun of chime: <br />„r' ~ Patented <br />I'. tl.:lddressra <br />1'upal~•ntrd <br />~- f d (' <br />~ tf~ ALA./~~~4_ <br />- - -- -- <br />'fatal I~~~rcu .• -----------~y_----~// `, n~•ren; unpulented <br />K- p~tented___-- __ //!'~__-- <br />Do You own or lease these claimel__-_. -- ~~ -'~` <br />!f You Lmse them give name of company or person frow whurn leased- <br />..----------- ~~--- ------- <br />-- (Over) <br />acrvrs <br />