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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />?? r. ? r <br />ANNUAL FEE and REPORT REQUEST <br />Hall Irwin Corporation <br />A-2000-144 <br />North LaPoudre Pit <br />January 22, 2009 <br />d/? <br />ecs <br />?ECE IVED <br />JAN 15 2009 <br />(Division ofa d Safety n <br />Mining <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 vour revised written annual report and annual report map 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 durin 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 <br />Fax Number: <br />t"Vl0-5$-1 --121"1 <br />CK'XO - 58'1 -17- 3-1 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below o attach it to this firm along witAyour written report and map. Annual Report instructions are enclosed. <br />of Cor}j6Wr Offid&/, Owner, or Designee <br />Date