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3 <br />8~ <br />Name of <br />Date of Original Locatio ___________. __________ <br />------------------ ------------- <br />location~_ _ _. _ _~_~~~~_~1~jt_ <br />--'---------------------------- G ---------------------- <br />\Iining Dist~rict// ~ ~ _ <br />County of.. LG4str~L___ _ ~ /J__________State of Colorado. <br />Title!ll...~4•_~1~~~~~//--_.Zly"__CiGrs~nrh//c~_~_e~~!~~1~t!//~~ES~,~~'__. containing_.rP_12________Acres, <br />vested in.6r10~vS.~__- - ~Cy_~*~tl___~•--`c.~'---------°----------------------- <br />`~-- - <br />---------------------------------- ------- ------ <br />/~~ ----------------------------------- <br />Principal Oftice ]ocated at__~liG_r_trtr_' _ <br />---`~lJ='------------------------------- <br />Branch 09ice at --- ---------------°---------------------- <br />Name a d Address O(ficers.---------------------------------------------- <br />-----------------------~-------~----------------------------------------------------------- <br />Course of Claim.-_~..+.1`r'erritrf~--~-~-y-~-_--~------Strike of Vein --~--------------- <br />Dip of Vein --- /?lc~,plat.w1•e------------------------------------------------ <br />Altitude at \[ain ~Vorki s __~~_ _~________________________________p________________.____ <br />Character of Countr+y..//Rock _~_-..!_,fx re_ ~=------------- <br />Characterof Vein_1:a~.w_4_.--__---_--------------------------------------------°------ <br />C~~y U <br />Character of Walls or Enclosing Rocks_!.v_2__ ''''`~__~_1-zce~___________ <br />Cha/ra~cter of Ore ._ _ __-~~~-~-*~-~}-~-aid <br />_~t- <br />Ore Occurrence ~~ - ---K+~+-~~~~~----°~---- <br />Devdo~ntilation Sanitary Condition, Exits ____-----°---------------°-------------- <br />---- <br /> <br /> <br />1'.~ <br />,.,, <br />i. <br />`, <br />:)I <br />t' <br />S` <br /> <br />;E <br />ai <br />'. <br />~, <br />~' <br />!' ~;', <br />+~~ ; <br />I;~: <br />t <br />(^ <br />f i'j'. <br />~?! <br />~~~; <br />r a, <br />t <br />'~ <br />~: <br />