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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Cotter Corporation <br />M-1979-094-HR <br />JD-7 Pit <br />December 14, 2003 <br />$550.00 (Due on or before your anniversary date) <br />Montrose <br />~~~~~ ., . <br />NOV 2 8 2003 <br />Division of Minerals and Ceolagy <br />According-to C.R.S. 34-32.5-116'or C.R.S. 34-32-116, each year, on the anniversary date of the petmit, amt <br />eperettor-shall-submit-the-ammai-fee,-a report-an~howm-~ g t tI a extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written anneal rennrt and anneal report m ~n fn thin form. please note that an <br />adequately Labe/ed map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David Diss <br />Permittee Name: Cotter Corporation <br />Address: P. O. Box 700 <br />Nucla, CO 81424 <br />(970)864-7347 <br />Fax Number: (970) 864-7287 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Stgnature of Corpor Officer, Owner, or Designee <br />t l/ z y/® j <br />Date J- <br />M;\PERMn1MASTERD000M ENTS/M-AF-@. DOC <br />