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~~ ~~ <br />PERMITTEE NAME: Hall-Irwin Corporation <br />PERMIT NO.: M-1983-090 REC EI V~® <br />OPERATION NAME: La Poudre Sand & Gravel DEC 2 7 2Qpy <br />ANNNERSARY DATE: January 17, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary d~~~'on of Minerals and Geology <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 yeaz, new disturbances that are anticipated to occur <br />during the upcoming yeaz, 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 ynnr revised written anneal ren~rt and anneal re`nrt main 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: Jim McFarland <br />Permittee Name: Hall-Irvin Corporation <br />Address: 3026 4th Ave. <br />Greeley, CO 80631 <br />Phone Number: (970) 352-6057 <br />Fax Number: <br />~~ G~Q~. <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 />~gSR,~rc o~ <br />~~r- <br />Owner, ar Designee <br />~J I Z/2z~o~l <br />Date <br />