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~ r-- <br />~a I <br />ANNU FE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Hall-Irwin Corporation <br />,/1•I-1998-013 <br />The Shores <br />October 1, 2007 <br />R oCE~VED <br />~ ~ 82007 <br />D>vision of Reclar~atlon, <br />~"'n9 and Safety <br />$$791.00 (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 disturbahces 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 report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />mau. If no new disturbances or reclamation have occurred during the previous year and no new chances to <br />the previous year's moo are necessary, then no new man 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 suffcce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jeff Gregg <br />Permittee Name: Hall-Irwin Corporation <br />Address: 301 Centennial Dr. <br />Phone Number: <br />Fax Number: <br />Milliken, CO 80543 <br />(970)587-7279 <br />(970)587-7289 <br />If you have additional comments and/or information that should be <br />below or attach it to this form along with your written report and map. <br />Si afore f Corporat fficer, Owner, or Designee <br />~~~~ log <br />Date <br />provided to the Division, please provide it <br />Annual Report instructions are enc]osed. <br />