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<br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST ~'~~~~ <br />~ ~ <br />Connell Resources, Inc. <br />®EC 1®?®OI <br />M-1999-050 Division <br />Minis ar ~~'`'~`~~apion, <br />Timnath Connell Pit g and t'afety <br />December 9, 2007 <br />$$791.00 (Due on or before your anniversary date) <br />Larimer <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, 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-per-formed 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 report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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 />Permittee Contact: Richard Connell <br />Permittee Name: Connell Resources, Inc. <br />Address: 4305 E Harmony Rd <br />Fort 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 />' C 1~C t <br />~gnature of Corporate Officer, Owner, or Designee <br />,~~.3 - 0 7 <br />Date <br />