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,._ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Hall-Irwin Corporation <br />M-1997-058 <br />Baseline Resource <br />February 12, 2004 <br />~/~.OK-- <br />RECEIVED <br />FEB 18 2004 <br />Division of Minerals & Gsolopy <br />8688.00 (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 opeeator <br />-shall submit the annual fl;e, a report and map showing the 'extent of current disturbances to affecied land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during [he upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and thy: date active operations ceased for the year, if any. <br />Please attach Ynnr revice~I written annnal report and annual report 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 />Permittee Contact: 3iaribf:Farlasd <br />Permittee Name: Hall-h win Corporation <br />Address: <br />Phone Number: <br />Fax Number: <br />P. O. I tox 519 <br />Greeley, CO 80632 <br />(39~}<i54-t~684 <br />(970) ' S2-6284 <br />C'it L, teoa <br />470 - 3sz - (~t,57 <br />If you have additional conments and/or information that should be provided to the Division, please provide it <br />below or attach it to this for n along with your written report and map. Annual Report instructions are enclosed. <br />L6LC <br />M:\PERMiTMASTEADOCUMEVrSN1-Al'-01 <br />