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<br />RECEIVE® <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Hall-Irwin Corporation <br />M-1983-090 <br />La Poudre Sand & Gravel <br />January 17, 2003 <br />JAN, 3 1 2003 <br />~, <br />Division ~f MMerals and AeoloAY <br />$688.00 (Due on or before your anniversary date) <br />Weld <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 yeaz, reclamation that will be performed during the coming yeaz, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach,ymn• revised written annual rennrt and anneal rennrt m1p to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice far a written report. <br />Division records indicate the Following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jim McFarland <br />Permittee Name: Hall-Irwin Corporation <br />Address: <br />Phone Number: <br />- - - Faz Number: <br />3026 4th Ave. <br />Greeley, CO 80631 <br />(970) 352-6057 <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 instmc[ions are enclosed. <br />oat r o C .~ O tcer, Owner, or Designee <br />Date <br />~f~~~~ <br />M:~PERMIT~MASTERDOCUMENTSVN-AF-01 <br />