REP43369

• Permit No: M1977284
• IBM Index Class Name: Report
• Doc Date: 9/21/2005
• Doc Name: Annual Report Packet
• From: DMG
• To: Cotter Corporation
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMiT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Cotter Corporation
M-1977-284
Mineral Joe Claims
June 16, 2005
$225.00 (Due on or before your anniversary date)
Montrose
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
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the
beginning of active operations, and the date active operations ceased for the yeaz, if any.
ch vour revised written annual report and annual report map to this form. Please note that an
labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Glen Williams
Permittee Name: Cotter Corporation
Address: P.O. Box 700
Phone Number:
Fax Number:
Nucla, CO 81424
[phone]
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it [o this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer or Owner
Date