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~ ~~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEENAME: /l3all-Irwin Corporation ~~~~i9\/~® <br />PERMIT NO.: ~lYI-1997-058 ~fiEB 0 5 2007 <br />OPERATION NAME: Baseline Resource D' ision of Reclamation, <br />M <br />i <br />ANNIVERSARY DATE: February 12, 2007 m <br />n9 and Safety <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) <br />COUNTY: 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 year, reclamation that will be performed during the coming year, t edates- oithe 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 />maD. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's man are necessary. then no new map is reuuired, 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 since 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 />Milliken, CO 80543 - - - --" - ~ _ ;'- <br />Phone Number: (970) 587-7279 <br />Fax Number: (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 re f orporate ~ fficer, Owner, or Designee <br />~~L~CZ~ <br />Date <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />