2004-01-20_REPORT - M1995035

• Permit No: M1995035
• IBM Index Class Name: Report
• Doc Date: 1/20/2004
• Doc Name: Annual Fee/Report Notice
• From: Connell Resources
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~~
Connell Resources
M-1995-035
Wellington Downs Pit
January 22,2004
RECEIVEQ
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:

JAN 2 02004
Division of Minerals & GaologY
$688.00 (Due on or before your anniversary date)
Larimer _ N
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'sutimit-the-annual-fee-a`report and-map-showing-the-extent-of-eurtent-disturbances to-affected-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 ym~r revised written annnal report and annual rennrt man to this form. 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:
Permittee Name:
David Simpson
Connell Resources
Address: 4305 E. Harmony Rd.
Phone Number: [phone]
Fax Number: [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.
.~~....~ c~_---
Signature of Corporate Officer, Owner, or Designee
Date
Fort Collins, CO 80528
M:\PERMITMASTERDOCUMENTSVvI-AF-01 v
M