2010-11-22_REPORT - M2003001 - Laserfiche WebLink

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c ? f AN UAL >F`EE nd PORT REOUEST PERMITTEE NAME: V /Hall Irwin Corporation PERMIT NO.: ?M-2003-001 OPERATION NAME: Nissen Farm Resource ANNIVERSARY DATE: November 21, 2010 ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) COUNTY: Weld R 4 + 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--cur-rent -disturbances to -affected-land,----- reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the date active operations ceased for the year, if any. Please attach vour revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map. If no new disturbances or reclamation have occurred during the previous Year and no new changes to the previous vear's map are necessary, then no new map is required, provided that the Operator shall state this in the Annual Report. 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: Permittee Contact: Jim McFarland Permittee Name: Hall Irwin Corporation Address: 301 Centennial Drive Milliken, CO 80543 Phone Number: (970) 587-7277 Fax Number: (970) 587-7287 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 wit"our written report and map. Annual Report instructions are enclosed. , or Designee Date