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'i� ` III IIIIIIIIIIIIIIII <br /> sss <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEE NAME: Connell Resources RECEIVED <br /> PERMITNO.: M-1995L"S JAN 19 2001 <br /> OPERATION NAME: Wellington Downs Pit <br /> Division of Minerals and Geology <br /> ANNIVERSARY DATE: January 22,2001 <br /> ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br /> COUNTY: Larimer <br /> According to C.R.S. 34-32.5-116 or C.R.S. 34-32-1 16, each year, on the anniversary date of the permit, an <br /> operator 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 /> beginning 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 map to this form. Please note that an <br /> adequately labeled nnctP that clearly delineates and includes the above elements tnav suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: David Simpson <br /> Pennittee Name: Connell Resources <br /> Address: 4305 E. Harmony Rd. <br /> Ft. 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 <br /> enclosed. C <br /> Signature of Corporate Ic or Owner <br /> "�\ :z\ �� <br /> Dat—�^� <br /> WPERM ITMASTERDOCUMENTSUM-AF-0 I <br />