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BUREAU OF LAND MANAGEMENT <br />COLORADO STATE OFFICE <br />_ ZOD"L <br />Filed for record this 12 ~ day of ,Ga.-~)%>r]5 ~ , ~ , A.D., at <br />.Reception No. Recorder <br />AFFIDAVIT OF LABOR AND liMPROVEMENT <br />STATE OF COLORADO, <br />SS. <br />t_ ~~ o County. <br />o clock _M- <br />Before me, the subscriber personally appeared , p1,~%/ G Dfl.~iP/~ ,who, being <br />duly~w~rn faith that at least /iU dollars worth of work or improvements were performed or made <br />upon,~he following described claim(s), situate in . <'rr~S.~s/ .~a_?!F,:. mining district, manly <br />of ~"~//t'~ ,state of Colorado, betwee the 3/S>~ day of, i4UG-rJ5T , <br />n#9~prji , A.D., and the (~~~ day of Srif~.~l6'~iP , ~ Z~Z, AD.: <br />CMC CMC <br />Claim Name (Serial Number) Claim Name (Serial Number) <br />i <br />_ ~' e - S <br />Uc C- 5~/ . <br />_ vc r- bz I <br />- e ~c-z 9 <br />V l~DX / i~I'C- 2 O !t3 <br />6l ~ .~C-Z o/ <br />~S l,~ MC- b .b <br />u i~ z <br />OLD ,VIA M - 7/ _ <br /> O <br /> r~ <br /> !_- <br /> <br /> <br /> ~,; <br /> <br /> <br />(Additional claims may be noted on the reverse side of this form) <br />Such expenditure was made by or at the expense of_ -.JUbEf%~ 1- si~~~I.S <br />owner of said claim(s), for the purpose. of complying_with the law, and holding said claim(s). <br />~C~1 /- <br />The mailing address(es) of the owner(s) of the above described claim(s) has/have been changed to. <br />2 9Z0 C,~d~i /%a;off f~~.~; v,~ (r> /.,~,~rL, 5~r/h,~ s <br />Subscribed and sworn to before me, this day, / ~ fj1_ of <br />d4 ztZ'Z, hD. <br /> <br />C50 JeOD-8 (Mav 1989) <br />