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nL. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />. ell Resources, Inc. <br />781-022 <br />Glass Gravel Pit <br />May 20, 2009 <br />?1? <br />RECEIVED <br />MAY I ? 2009 <br />i?iaioa of RaGl:ma*)A, <br />M:v-lg and Safety <br />$$791.00 (Due on or before your anniversary date) <br />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 <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 vour revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Larry Johnson <br />Permittee Name: Connell Resources, Inc. <br />Address: 7785 Highland Meadows Pkwy., Ste. 100 <br />Fort Collins, CO 80528 <br />Phone Number: (970) 223-3151 <br />Fax Number: (970) 233-3191 <br />If you have additional comments and/or information that should be <br />below or attach it to this form along with your written report and map. <br />Date <br />Utticer, Uwner, or vesignee <br /> <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />/1 p /9 ek) (hr Su ? UGWca S © r, <br />re c lWm Yl?m 4.4 (-? AeLS may, <br />y