2017-01-17_REPORT - M1993059

• Permit No: M1993059
• IBM Index Class Name: Report
• Doc Date: 1/17/2017
• Doc Name: Annual Fee/Report Notice
• From: DRMS
• To: Midwestern Farms
• Annual Report Year: 2017
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

Page 5 of 5

Division records indicate the following permittee/landowner contact information (blank fields indicate that we do not have
information on record). If this information is blank or not current , please type or print current contact information:

Permittee Contact:

George Tempel
Permittee Company:

Midwestern Farms
Address:

P.O. Box 246
Wiley, CO 81092

Phone Number:

[phone]
Fax Number: [phone]
Email Address:
Permitting Contact:

Joe C. Baxter
Company:

Eastern Colorad Aggregates
Address:

P.O. Box 580
Rye, CO 80169

Phone Number:

[phone]
Fax Number: [phone]
Email Address:
Inspection Contact:

Joe C. Baxter
Company:

Eastern Colorado Aggregates
Address:

P. O. Box 580
Rye, CO 81069

Phone Number:

[phone]
Fax Number: [phone]
Email Address:

I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.

Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
M-AF-01