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,. . . � • iiiiiiiiiii <br /> ANNUAL FEE and REPORT REOUEST 414 <br /> PERMITTEE NAME: Cotter Corporation oecel <br /> PERMIT NO.: M-1977-305 F88 2.9 �nr9 <br /> OPERATION NAME: CLP-21 Mine <br /> ANNIVERSARY DATE: March 31,2001 J ueolagy <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 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'vour revised written annual report and annual report map to this form. Please note that 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: David Diss <br /> Perm ittee Name: Cotter Corporation <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 /> . 6 <br /> Signature of Cor orate Officer or Owner <br /> a�zt/d/ <br /> Date <br /> M1PERWIVAASTERDacumerrrsa r-AF-02.Doc <br />