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<br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Cotter Corporation <br />M-1984-014 <br />JD-S Mine <br />October 10, 2003 <br />SEP 2 0 2003 <br />Division ~1 Minerals and Geology <br />$550.00 (Due on or before your anniversary date) <br />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 hall-subrr}it-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 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 atfachynnr revised written anmral rennrt and annnal rennrl ma,~n to this form. Please note [hat an <br />adequately labeled map that clearly delineates and includes the above elements may suffice 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: Havid-Him <br />Permittee Name: Cotter Corporation <br />Address: P.O. Box 700 <br />Nucla, CO 81424 <br />G~2h ~/~JilliGlms <br />Phone Number: <br />Fax Number: <br />(303) 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 />Signature of Corporate Officer, Owner, or Designee <br />Date <br />M:~PERM ^Vvl ASTERDOCUMENTS/M-AF-02. CK1C <br />