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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />iii iiiiiiiiiiiuiii <br />999 <br />ANNUAL FEE and REPORT REQUEST <br />Cotter Corporation <br />M-1977-451 <br />Ike No 1 Mine <br />February 15,2002 <br />RECEIVE® <br />JAN 2 8 2002 <br />®ivisian of Minerals and Geology <br />$550.00 (Due on or before your anniversary date) <br />San Miguel <br />According [o 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 submit 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 [he 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 vnur revised written annual report and annual report m:,n to this form. Plrn.~r nntr rlrnt rnr <br />ndeyuureh lubrled nrup dart cleur(1 deluteures and inchrdes the ubul'e elenrrnrs nrur au/Dice jar a lrrinen <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 />Phone Number: <br />Fax Number: <br />Nucla, CO 81424 <br />(970)864-7347 <br />(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 />/ ~t <br />Signature of Corp rate Officer or Owner <br />~/z ~/o L <br />Date <br />Al 8'ERP1I"MIASTERD0001.tENTS/M-AE 02.DnC <br />