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v <br />~ fJil~ <br />ANNiiAi. FF.F, and RF.PnRT RF.nITF.ST r, <br />PERMITTEE NAME: ~ Connell Resources, Inc. ~~~~~ V ED <br />PERMIT NO.: ~ M-1981-022 MAY 192006 <br />OPERATION NAME: //Glass Gravel Pit <br />!/ ~Divisioo of Mieerats aadGeo>o~ <br />ANNNERSARY DATE: May 20, 2006 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Larimer <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 I <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 I <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 ~y~r revised written anmial re}Inrt and anneal rr,~prt mgt, to this form. Please note 1haJ an <br />adequately labeled map that clearly delineates and includes the above 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: Richard Connell <br />Permittee Name: Connell Resources, Inc. <br />Address: 4305 E. Harmony Rd. <br />_ Phone Number: <br />Fax Number: <br />Fort Collins, CO 80528 <br />(970) 223-3151 __ <br />(970) 233-3191 <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 />S' ature of Corporate O titer, Owner, or Designee <br />-17-O1o <br />Date <br />