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<br />ec s <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />T_ <br />ANAX FtE and REPORT REOUEST <br />r - Hall Irwin Corporation <br />/M-2003-001 <br />Nissen Farm Resource <br />November 21, 2008 <br /> <br />'OCT 1 0 2003 <br />ot! ,917 U, ;;;G; <br />Wfiirii2ne and S6* <br />$$791.00 (Due on or before your anniversary date) <br />Weld <br />old <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 />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new may 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: Jim McFarland <br />V?;ce Pres??9e?-t- <br />Permittee Name: Hall Irwin Corporation <br />Address: 301 Centennial Drive <br />Milliken, CO 80543 <br />Phone Number: F99$}fi5?=6957 ?i ?l ?J ?J 'g }1 -1 Z ?l <br />Fax Number: <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 forjp along with yqur written report and map. Annual Report instructions are enclosed. <br />, or Designee <br />Date