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<br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNiJAL FEE DUE: <br />COUNTY: <br />,~~: ~~r <br />ANNUAL FEE and REPORT REQUEST <br />'Cotter Corporation <br />'~ M-1977-305 <br />C-LP-21 Mine <br />March 31, 2008 <br />$$633.00 (Due on or before your anniversary date) <br />Montrose <br />~ MAR <br />p~ ~ ®~~~$ <br />/ Vain n °' ~teciarnation <br />9 and Satety ' <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-reportand-map-showing~the-extent of current disturbances-te-affee-ted-- - _---_ <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcc-ming 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 map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durinE the previous year and no <br />new changes to the previous year's map are necessary, then no new map is reauired, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: ~31en Williams <br />Permittee Name: Cotter Corporation <br />Address: 1P.0. Box 700 <br />]vucla, CO 81424 <br />Phone Number: 1;970) 864-7347 <br />Fax Number: j 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 thhis form along with your written report and map. Annual Report instructions are <br />enclosed. <br />~~ ~ <br />~-~ <br />Signature of Corporate Officer, Owner, or Designee <br />~~' <br />Date <br />M:~PERMIT~MASTERDOCUME]VTS/M-AF-02. DOC <br />