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:- <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />-• - <br />~II ~I~II~II~II~~ ~II <br />ANNUAL PEP, ana9xr,rvtci xEOUEST <br />Connell Resources <br />Timnath Connell Pit <br />December 9, 2000 <br />~tECEIVED <br />DEC 0 7 2000 <br />pivision at Minerals and Geola9Y <br />$688.00 (Due on or before your anniversary date) <br />Larimer <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I16, each year, on the anniversary date of the permit, an <br />pperator 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 Hole that on <br />adequately labeled map that clearly delineates and includes the above elements may 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: Richard Connell <br />Permittee 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. <br />` ;~, ~~ ~~ <br />Signature of Corporate Ot~icer or Owner <br />to ~S~~a~,~ l.~ <br />Date <br />hf:~PERh1ITMA5TERDOCUh1ENTSVd-AF-0 I <br />