2004-09-27_REPORT - M1978116

• Permit No: M1978116
• IBM Index Class Name: Report
• Doc Date: 9/27/2004
• Doc Name: Annual Fee/Report/Map
• From: Cotter Corporation
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~sS

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Cotter Corporation
M-1978-116
SM-18 Mine
October 30, 2004

SEP 2 ~ 204
~ieision of {':Jf6iL~. 6: Gxni¢CY
$550.00 (Due on or before your anniversary date)
Montrose
According to C.R.S. 34-32.5-t 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accom}ilished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written anneal re¢prf and anneal repQJ'Lmgp to his form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Glen Willliams
Permittee Name: Cotter Corporation
Address: P.O. Box 700
Phone Number:
Fax Number:
Nucla, CO 81424
[phone]
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
Signature of Corp ate Officer, Owner, or Designee
si~y/~y
Date / /
M:~PERMITVv1ASTERD000MENTS~M-AF-02.DOC