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<br />1~°'~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Hall-Irwin Corporation <br />M-2000-144 <br />North LaPoudre Pit <br />January 22, 2005 <br />~/ <br />R~~~eV~® <br />Ofd 17 20py <br />Division o/Minerals and Geology <br />$688.00 (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 fot [he beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attachyn~r revised written annnal rennrt and annual re,Pnrf map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jeff Gregg <br />Permittee Name: Hall-Irwin Corporation <br />Address: 3026 4th Ave. <br />Greeley, CO 80631 <br />Phone Number: (970) 352-6057 <br />Fax Number: (970) 352-6284 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attpch it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Owner, or Designee <br />I Z ~22~0~( <br />Date <br />