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w _ ,.. ~~ <br />`-~"`"~ <br />,~, 0 ,. ~"~ MINE REPORT X21 <br />ote-Please 8ll oat this report carefully, write plainly and answer all questions fully. Be sure to <br />ste the report and sign it. Fill out bath sides of the sheet. <br />~Jlhh... W <br />-----------`~=U--------------. Colorado, -1/~z_u-rrin~is_'_---,f~/i. 19~5~ <br />BUREAU OF DIINI;S, STAT); OF COLORADO. <br />T. R. Henatlen, Commissioner of ilIinca, <br />Denver, Colorado. <br />Sir: In accordance with Section 4299, Revised Statutes, Colorado, 1908, I submit report as follows: <br />Name of Company-Tho_________(~y~y~E/ ~~ <br />---------- <br />Incorporated in the State oP_________!!____ <br />--------------------------------------- <br />~i <br />Principnl of#'ice ___________________ <br />u a Cam9.nr, Capital stock ------------------- i/___-- Shares, at :~----_----_-- Per share. <br />011 ovt t6b <br />•D•ne• nmet.t.. Name P. 0. Addresses <br />lesm It hl.vk <br />President -------.r_±c~x?c.-.=-------------------- <br />----------------------------- <br />Secretnry ___________ i'_ <br />------ -------------------- <br />Trensurer i' <br />----- -------------------- <br />`\tannger ----------~~--------------------------- <br />t <br />Title of Partnership-___--- -,~~ic r-------------------------------------- <br />------- <br />Pnrtnrrs' Names P. 0. A~jddress <br />____.C _ ^x/_aJL.-t`~22-~~Q_L_'~I_2C'Y-f~N_______ ,~"~ e. ti ~. <br />ar D.rtv<nhlp V <br />GII out thl. -----_------ _ <br />_________________________________ <br />Inre I[ Dl.vk <br />Afnnager ----------- ------------------------ -------------------------------- <br />J __ <br />c[.~-~- <br />:~rJrtEt/ <br />psRY• <br />'* - <br />~ Nnmes of Owners P. 0. Addresses <br />-_____~<_2f /1 ". c~f~y_s_21?(~_~________.. ___________l/_~EY_i_t ~__LCfC4L`~__ <br />If oelther ________________________________________. <br />mmP.v7 vor <br />n~ttnenhlpp, <br />ell out tiJ. ----------------------'___-'-_-______-__--__ -__-----___---___'___-__-----_'__ <br />.p.n <br />3[anagur----------------------------------- --------------------------------- <br />State names of claims: <br />Pulsated. <br />J / "1/ ~ , t <br />.__.______L ~~O1 Y_v_c_}_z~_~~__ <br />--- <br />Unpntented <br />-----'/~z~y~r_z^m3'~ ----------------- <br />,.. <br />---------------------------------------------- ---------------------------------------------- <br />' _acres; unpntented_______________________~y _acrea <br />fotnl acreage patented___________________2~4_ / <br />Do yon own or lease these clnimsT__________~~rn__1~i+rr~-z.~-------------------------------- <br />If you lease them give name of company or person from whom leased___crr-~3:v____________________ <br />----------------------------------------------------------------------------------------------- <br />(Over) <br />~~i <br /> <br />