2005-10-19_REPORT - M2003001

• Permit No: M2003001
• IBM Index Class Name: Report
• Doc Date: 10/19/2005
• Doc Name: Annual Fee/Report/Map
• From: Hall-Irwin Corporation
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNTiAi. FF.F, and RF.PnRT RF,niiF.AT
~H -Irwin Corporation
M-2003-001
Nissen Farm Resource
November 21, 2005
~/Y1
RECEeVED
~CT 191005
}~ Division of Minerals sod Geology
RECFivEp
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$688.00 (Due on or before your anniversary date) "' '°°° - ---- --._,,,
Weld

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 current-disharbances 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 ~nnr reviced written annual report and anmral report man to fhic form. 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 petmittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Jeff Gregg
Permittee Name: Hall-Irwin Corporation
Address: 301 Centennial Dr.
Milliken, CO 80543
Phone Number: [phone]
Fax Num- e-6 r: 'j~70}-332-?iZ84-~-
470 -S'87~ 7279
-9x~-- ~~-- X89 --
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 wi your written report and map. Annual Report instructions are enclosed.
Owner, or Designee
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Date