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t <br />PERMITTEE NAME <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />o/< <br />ANN A EE and PO T REQUEST <br />11 Irwin Corporation <br />111 ' M-2000-144 <br />North LaPoudre Pit <br />ec s <br />CFfVr--D <br />JAN 2 5 2010 <br />Divisi0ri ui rcriCQrna*M+ <br />'may, wifl11'1(J and Sd* <br />January 22, 2010 <br />$$791.00 (Due on or before your anniversary date) <br />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 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 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: Jim McFarland <br />Permittee Name: Hall Irwin Corporation <br />Address: 301 Centennial Drive <br />Milliken, CO 80543 <br />Phone Number: (970) 587-7277 <br />Fax Number: (970) 587-7287 <br />If you have additional comments and/or <br />below or attach it to this form along with <br /> <br />that should be provided to the Division, please provide it <br />report and map. Annual Report instructions are enclosed. <br />Owner, or Designee <br />_l j9 1dlo <br />Date