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~ III Illilllillllllll <br />999 <br />ANNUAL tc>~rvn;z' <br />PERMITTEE NAME: Hall-Irwin Construction Co. <br />PERMIT NO.: M-96-060 <br />OPERATION NAME: Firestien Pit <br />ANNNERSARY DATE: December 31, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Weld <br /> <br />palll <br />(;ECEIVED <br />NOV 0 4 ~ggg <br />;..nn of rdinerab & Geology <br />According to C.R.S. 34-32.5-116(3)(a), each yeaz, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of cueent disturbarccs to affected <br />]and, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year. the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that un adeyrtntely lnbeled mnp that clenrly delineates and includes dre above elenretus nrny <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: U r`P <br />Adddress: ~A• ~cyt 5 I ~' <br />~- , L~ tTC IP ` ~G 3 z. <br />Company: f-~.~ ~ - ..1rw.,,~ <br />Phone No.: (9b) c~5-Z - lsGS7 <br />Fax No.: (927) ,~S'2 - [~Z85/ <br />If there are additional comments and/or information that should be provided [o the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Owner <br />lie ~7 <br />Date <br />/NSTRUCTIONS ON BACK <br />~, <br />