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<br />t CJ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Connell Resources <br />M-1995-035 <br />Wellington Downs Pit <br />January 22,2005 <br />$688.00 (Due on or before your anniversary date) <br />Larimer <br />RECEIVED <br />JAN g I ,~ <br />Division afMinerals and Geology <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 anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />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 maw to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David Simpson <br />Permittee Name: Connell Resources <br />Address: 4305 E. Harmony Rd. <br />Fort Collins, CO 80528 <br />Phone Number: (970) 223-3151 <br />Fax Number: (970) 223-3191 <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 enclosed. <br />r <br />ignature of Corporate Officer, Owner, or Designee <br />1~26~9~ <br />Dale <br />