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<br />,~~~ • ~ III IIIIIIIIIIIIIIII ~ ~ <br />• ANNUAL FEE and REPORT REQUEST <br />REG~: ~ "c G <br />PERMITTEE NAME: Connell Resources <br />PERMIT NO.: M-1999-050 DEC 1 1 2001 <br />OPERATION NAME: TimnathConnellPit DivblanofMinaraleandGeuloBY <br />ANNIVERSARY DATE: December 9, 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. 34-32-116, 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 reuort man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pemtittee 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 enclosed. <br />Signature of Corporate Officer or Owner <br />/ii - 7-~ O/ <br />Date <br />M:W ERA1mMASTERD000MENTSUI~AF~01 <br />