CHIEF FIRE WARDEN. 9' 



were found (state whether on one, and which, or both sides of the 

 right-of-way and what breadth of the right-of-way from center of 



the track) 



Such combustible material extended along the right-of-way a 



distance of about (state number of rods or miles) 



and between (indicate by village, stream, farm or other object) 



and 



Adjoining the right-of-way where such combustible material was 



found there was on (state which side) the side (state 



whether timber, bushes, stubble, grain in shock or stack, hay in 

 shock or stack, or what property and whose, if you know, that 

 could be damaged or endangered by the spread of fire, and about 

 to what extent. If there was property on both sides of the right- 

 of-way that could be endangered by fire spreading from combusti- 

 ble material on the right-of-way, so state and describe the same. 

 Be particular and follow these instructions carefully) 



The weather was 



Name and address of the witness who accompanied the under- 

 signed is 



P. O Signature 



Date Named of Organized Township 



SUMMARY OF FOREST FIRES, 1903. 



