2010-09-01_REPORT - M1984014

• Permit No: M1984014
• IBM Index Class Name: REPORT
• Doc Date: 9/1/2010
• Doc Name: 112d-1 Annual Fee Invoice and Report Request
• From: DRMS
• To: Cotter Corporation
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REOUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Cotter Corporation
M-1984-014
C-JD-8
October 10, 2010
$1,150.00 (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 sUDIlllt the annual lee, a report and nlap S-11 0Wliln U1C extellt 01 GUI1-011L UIJLUlOURCGJ LO a11GGLGU
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 year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual report and annual report man to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated map. If no new disturbances or reclamation have occurred during the previous year and no
new chances to the Previous vear's map are necessarv, then no new man is reauired, provided that the
Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly
delineates and includes the above elements may suffice 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 to this form along with your written report and map. Annual Report instructions are
enclosed.
Signature of Corporate Officer, Owner, or Designee
Date
M:\PERMTT\MASTERDO(:UMENTS/M-AF-02.DOC