2002-01-22_REPORT - M1995035

• Permit No: M1995035
• IBM Index Class Name: Report
• Doc Date: 1/22/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:

ANNUAL FEE and REPORT Rl;OUEST
Connell Resources

RECEIVED
M-1995-035 SAN 2 2 2002
Wellington Downs Pit of Mlinerals and Geology
pirision
January 22, 2002
$688.00 (Due on or before your anniversary date)
Larimer
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 submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming yeaz, reclamation that will be performed during the coming yeaz, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map 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: David Simpson
Permittee Name: Connell Resources
Address: 4305 E. Harmony Rd.
Ft. Collins, CO 80528
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 instmctions are enclosed.
Dave Simpson
ia@- e 'dent
Signature of Corporate ficer or Owner
L~~ `-`.?
Date
M iPERMffN1 ASTERDOCUh1ENTSV.I-AF-01