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~~ ~ ~~ <br />ANNUAL FEE and REPORT REQUEST / ~~~ <br />PERMITTEE NAME: Connell Resources, Inc. ,/ / JUN ~ ~ 20,9 <br />©IlSt~%~ 01' tSSC'^ <br />PERMIT NO.: M-2006-084 / ~ 19~li~, and '-m~-a.,. <br />S~te~ <br />OPERATION NAME: White River City Pit <br />ANNIVERSARY DATE: June 11, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <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 your revised written annual report and annual report man 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 vear and no new changes to <br />the previous year'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 cuff ce 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) 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 map. Annual Report instructions are enclosed. <br />Sign re of C or e fficer, Owner, or Designee <br />~-k~ ~? ~q <br />Date <br />