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~~' <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Connell Resources <br /> <br />M-1999-050 DEC ~ 8 <br />Timnath Connell Pit division o! Minerals and 6eplodV <br />December 9, 2003 <br />$688.00 (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-] 16, each year, on the anniversary date of the permit, an operator <br />---shall-submit-the-annual fee,-a-report-and-map-strowirtg-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 ymrr revised written annnal rennrt and annnal re nn rt maw to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pertnittee Contact: Richard Connell <br />Permittee Name: Connell Resources <br />Address: 4305 E. Harmony Rd. <br />Fort Collins, CO 80528 <br />Fax Number: (970) 223-3191 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />- ' 1r,_~ <br />Signature of Corporate Officer, Owner, or Designee <br />/2. p~ ..vim <br />Date <br />MiPERM ITUTASTERDOCUM ENTSUI-AF-01 <br />