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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE; <br />ANNUAL FEE DUE: <br />COUNTY: <br />Wri" <br />ANNUAL FEE afCd R PORT REQUEST <br />Cotter Corporation <br />NI-1977-300 <br />Schwartzwalder <br />September 28, 201 `1' <br />$633.00 (Due on or before your anniversary date) <br />Jefferson <br />Jbz <br />RECFEI Y EV <br />JAN 1 12010 <br />Division of Reclamation, <br />Mining & Safety <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 operator <br />_ shall submit- the annual fee, a -report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipate fo occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of <br />active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report an to this form. The Annual Report & <br />Fee requirement Is not met until we have received the following components: fee report and associated map. <br />If no new disturbances or reclamation have occurred during the previous year and no new changes to the <br />previous year's map are necessary, then no new map is required provided that the operator shall state this <br />in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above <br />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: Gus Gaviotis <br />Permittee Name: Cotter Corporation, Schwartzwalder Mine <br />Address: 7800 E. Dorado Place, Ste. 210 <br />Englewood, CO 80111 <br />Phone Number: (720) 554-6211 <br />Fax Number; - (720) 554-6201- <br />if you have additional comments and/or information that should be provided to the Division, please provide it below <br />or attach it to this font along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />©K- <br />M: PERMIT\MASTERDOCUMENTS/M.AF.02.OoC