2017-09-22_REPORT - M1977300

• Permit No: M1977300
• IBM Index Class Name: REPORT
• Doc Date: 9/22/2017
• Doc Name: Annual Fee/Report/Map
• From: Cotter Corporation
• To: DRMS
• Annual Report Year: 2017
• Email Name: MAC
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have
information on record). If this information is blank or not current, please type or print current contact information:
Permittee Contact: Stephen J.Cohen
Permittee Company: Cotter Corporation
Address: 7800 E. Dorado Place, Suite 210
Greenwood Village,CO 80111
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
cotterusa.com
Permitting Contact: John Hamrick Stephen J. Cohen
Company: Cotter Corporation
Address: 0502 County Road 68
P.O. Box 1750 1700 County Road 143
Canon City, CO 81212 Canon City, CO 81212
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail] (�
Inspection Contact: John Hamrick Stephen J. Cohen [/
Company: Cotter Corporation
Address:
P.O. Box 1750 1700 County Road 143
Canon City,CO 81215 Canon City, CO 81212
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
1,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.
�'P /5- /
Signature of6kermWee,Cor orate Officer,Owner,or Documented Designee Date
M-AF•Oa'