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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Cotter Corporation <br />M-1977-311 <br />SR-13A Mine <br />August 31, 2002 <br />R~~F~a/ED <br />JUL 2 9 Za-y <br />Division of Minerals and (lealeg~ <br />$225.00 (Due on or before your anniversary date) <br />San Miguel <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-curent 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 your revised written annual report and annual report maa to this form. Please note that an <br />adegaately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permi[tee 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 />^ Z <br />Signature of Co o ate Officer or Owner <br />~~/ 7 ~o i~ <br />Date <br />M:~PERM77lMA5TERD000M ENTS/M-AF-02.DOC <br />