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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-1978-286-HR <br />Liberty Mine <br />November 1, 2003 <br />~~c~rv~® <br />OCT 2 72003 <br />Division of Mineralsand (3eologr <br />$225.00 (Due on or before your anniversary date) <br />Mesa <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 permit, an <br />operator-shall-suhmit-the-annual-fee,-a-report and-map-showing_the 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 ~~r revised written annual report and anm~al reFnrt marn to this inrm_ please note that an <br />adequately labeled 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: -~id~H15S G~2 h inJi' ~ ~ i G1 Yvt 5 <br />Permittee Name: Cotter Corporation <br />Address: P.O. Box 700 <br />Nucla, CO 81424 <br />__._P_honeNumber:~(9.7.0).864=2347 __ <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 />~~ <br />Signature <br />Officer, Owner, or Designee <br />1°%~~a3 <br />Date <br />M:~PERMi1lMASTERD000MENTSIM-AP-02.DOC <br />