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©K. <br /> <br /> ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: kall Irwin Corporation <br />PERMIT NO.: e4_1998-013 <br />OPERATION NAME: The Shores <br />ANNIVERSARY DATE: October 1, 2008 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Weld <br />tl?' L=] 1V_0r) <br />CEP '17 2008 <br />Division or i-reclamation, <br />-IV {dining and Safebi <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 your revised written annual report and annual report may to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's map are necessarv, then no new man is reauired, provided that the Onerator 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: Jim McFarland <br />\/', CC 1P.res,;7 c?-e r1' <br />Permittee Name: Hall Irwin Corporation <br />Address: 301 Centennial Drive <br />Milliken, CO 80543 <br />Phone Number: <br />Fax Number: <br />If you have additio <br />belo r attach i to <br />r a <br />g -1O - 5 S -1 - -I Z -1 "1 <br />2? -JQ ' S8-1- -12 81 <br />comments and/or information that should be provided to the Division, please provide it <br />form O%ng w written report and map. Annual Report instructions are enclosed. <br />, or Designee <br />V(A-5 - 2003 <br />Date <br />