2001-11-29_REPORT - M1987166

• Permit No: M1987166
• IBM Index Class Name: Report
• Doc Date: 11/29/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

PERMI'ITEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Westhoff Farms
M-1987-166
Westhoff Farms
December 1, 2001
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RECEIVED
NOV 19 2001
Uiuisian of Minerals and GeoloBY
$281.00 (Due on or before your anniversary date)
Morgan
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual report and annual report map to this form. Please note that nn
adegnate!}~ labeled map that clearly delrrteares nrtd includes the above elements may sake for a writeerr report.
Division records indicate the following permi[[ee contact information. Please verify and make any necessary
changes: ,~
Permittee Contact: Joseph E. Westhoff
Permittee Name: Westhoff Farms
Address: 2823 RD3
Wiggins, CO 80654
Phone Number: [phone]
Fax Number: [phone]
q 1 c1 4 g3 - s3- G ~ ~
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
ignature of Corplorate Officer r Owner
~~ /~~/ y )
Date
M:~PERh1I"rN1A$TER DOC U M ENTSV.1-A F-01