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FROM • 91.09.2081 11:25 P. 02 <br />• <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Connell Resources <br />NI-1999-050 <br />Timuath Connell pit <br />becember 4, 2000 <br />$688.00 (Due on or before your anniversary date) <br />Latimer <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, en <br />pperator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />~begimiing of active operations, and the date active operations ceased for the year, if any. <br />revised written aenusl report and annual report man to this form. Please note that an <br />n:ap that clearly delineates and includes the above elements Wray suffice for a wrltren <br />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 <br />Address: 4305 E. Harmony Rd. <br />Ft, Collitts, 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 tnap. Annual Report instructions are <br />enclosed. <br />Y~ <br />Signature of Corporate Off cer or Owner <br />lO L~~~>.~8~1~ ~~~ <br />Date <br />~-NNUAL FEE and RF,pORT REQUEST <br />MV ERA4TVaASTERD000F¢NTSU1•AF-01 <br />