2004-05-24_REPORT - M1981022

• Permit No: M1981022
• IBM Index Class Name: Report
• Doc Date: 5/24/2004
• Doc Name: Annual Fee/Report/Map
• From: Connell Resources Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIi/f~~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Connell Resources, Inc.
M-1981-022
Glass Gravel Pit
May 20, 2004
$688.00 (Due on or before your anniversary date)
Latimer
MAY 2 42004
Diuisian of Minerals and Ceolagy
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,
reelarrlaYron accumplislted'to date and-during the~pteceding year; new disiurbances that aie-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 your revised written anneal report and annual re rrn t maP to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may sufftce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: David E. Simpson
Permittee Name: Connell Resources, Inc.
Address: 4305 E. Harmony Rd.
Fort Collins, CO 80528
Phone Number: [phone]
Fax Number: [phone]
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.
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Signature of Corporate Officer, Owner, or Designee
Date