REP48516

• Permit No: M1983090
• IBM Index Class Name: Report
• Doc Date: 1/12/2004
• Doc Name: Annual Fee/Report Notice
• From: Hall-Irwin Corporation
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Hall-Irwin Corporation
M-1983-090
La Poudre Saud & Gravel
January 17, 2004
$688.00 (Due on or before your anniversary date)
Weld -
JAN 1 2 2004
Division o; t~,7inerals and Geology
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
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
Teclamation accomplished-fo dat`e and-during=ihe preceding-year, new-disturbances-that-are-anticipated-to-occur- --
during the upcoming year, reclamation that will be performed during the coming year, [he dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual rennrl and annnal report m to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes: l~
Permittee Contact: Jim McFarland lJ f
Permittee Name: Hall-Irwin Corporation
Address: 3026 4th Ave.
Greeley, CO 80631
Phone Number: [phone]
Fax Number: ~ 7 $L~-
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Uwner, or Designee
u
Date 1/~/~
M:~PERMITNIASTERDOCUMENTSUI-AF-01 -