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~~ <br />~~ <br />ANNTiAi. FF.F, and RF,PTIRT RF.nTTFST <br />PERMTTTEE NAME: Cotter Corporation ~~ , <br />PERMIT NO.: M-1979-094-HR <br /> ~l)Sl <br />~~~ l 3 ( <br />OPERATION NAME: . <br />JD-7 Pit <br />ANNNERSARY DATE: December 14, 2004 _~ '• ° ^:-~- <br />ANNUAL FEE DUE: $550.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <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 submit the annual fee, a report and map showing the extent of current disturbances to affected <br />- ~ land, reclamation acoomplished 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 y nor revised written anneal report and anneal report m ~n to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since 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: Baaid-HiSS' <br />Permittee Name: Cotter Corporation <br />GCe,-. ~,~~~I~~G~,,s <br />Address: P.O. Box 700 <br />Nucla, CO 81424 <br />Phone Number: (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 />'/ ' <br />S'gnature of Corpor to Officer, Owner, or Desi ee <br />i~/6/,~~ <br />Date <br />M:IPERMITNIASTEADOCUMENTS/M-AF-02.DOC <br />