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ANNUAL FEE and REPORT REQUEST ~~C~~VE® <br />PERMITTEE NAME: Hall-Irwin Corporation ~pN 2 2 2008 <br />PERMIT NO.: M-1983-090 Division or rteclamation, <br />OPERATION NAME: La Poudre Sand & Gravel Mining and Safety <br />ANNIVERSARY DATE: January 17, 2008 <br />ANNUAL FEE DLTE: $$791.00 (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, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour 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 />map. If no new disturbances or reclamation have occurred durin8 the previous year and no new changes to <br />the previous year's map are necessary, then no new map 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 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: 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 provided to the Division, please provide it <br />below or ttach it this form along with your written report and map. Annual Report instructions are enclosed. <br />ature f Corporate rcer, Owner, or Designee <br />1 <br />Date <br />