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~` 1 <br />ANNUAL FEE and RE ORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~ Cotter Corporation <br />/iGI-1977-305 <br />C-LP-21 Mine <br />March 31, 2007 <br />~NS ~ ~ ~ ~ ~~;~ <br />~~R ~ ~i <br />Dl~i ~, 17nn, <br />~i%i,~ ~ ~_ ~ .. <br />_ ~~ i <br />$$550.00 (Due on or before your anniversary date) <br />Montrose <br />__-According.to.C.R.S. 34-32.5=1 I6 or_C.R.S..34.32_116, each year,_on the anniversary_date.ofthc 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 yeaz, 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 vour revised written annual report and annual renort mau to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, renort, and <br />associated man. If no new disturbances or reclamation have occurred during the previous year and no <br />new chances to the previous year's mau are necessary, then no new maa is required, arovided that the <br />Operator shall state this in the Annual Resort. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following petrnittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Glen Williams <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. , n <br />Signature of Corporate Officer, Owner, or Designee <br />33-5~7 <br />Date <br />M:IPERMITMASTERDOCUMENTS/M-AF-02.DOC <br />