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IUR-22-O4 14:24 FROM-Colorado Division of Minerals 8 Geology +13038663567 <br />C~ /i <br />ANNIL47. F .F, nrl RF.PnRT RF.(IiTF.CT <br />PERMITCEE NAME: Cotter Corporation <br />PERMIT NO <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />M-1977-305 <br />CLP-21 Mine <br />March 31, 2004 <br />T-130 P.002/002 F-664 <br />RECE!`s~~ <br />MAR 3 0 2004 <br />Divieion of Minea~. a GeoloAY <br />$550.00 (Doe on or before your anniversary date) <br />Montrose <br />According to CRS. 34-32.5-116 or C.R.S. 3432-116, each yeaz, on the anniversary date of the permit, an <br />operator shall submit tht 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 yeaz, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach y~lr revicgd written anneal report and annual report maP to thic fnrm_ 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 />Pemrittee Contact: Baayd-Hiss <br />Pertnittee Name: Cotter Corporation <br />Address: P.O. Box 700 <br /> <br />Nucla, CO 81424 <br />Phone Number: (970) 8147347 <br />Fax Number: (970) 8147287 <br />If you have additional comments and/or information that should &: 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 />Signature of C to Officer, Owner, or Designee <br />.~ S p <br />Dat¢ <br />MMERMnVNASTENDOCUMkNTtiIM.AF•0'1.IXx <br />