2007-02-07_GENERAL DOCUMENTS - M1995035

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ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNNERSARY DATE ANNUAL FEE DUE: COUNTY: Connell Resources, Inc. M-1995-035 Wellington Downs Pit January 22, 2007 $$688.00 (Due on or before your anniversary date) Larimer 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 aze 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 year, if any. Please attach vour revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated maa. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to the previous year's man are necessary. then no new map is required, provided that the Ouerator shall state this in the Annual Resort. Please note that an adequately 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: Richazd Connell Permittee Name: Connell Resources, Inc. Address: 4305 E. Harmony Rd. Fort Collins, CO 80528 Phone Number: (970) 223-3151 Fax Number: {970) 223-3191 If you have additional comments and/or information that should be provided to the Division, please provide 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