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uC~ VY~ CGQ. <br />l.~ __~t ______ <br />a ' <br />f- <br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPCRATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Mldwestora Farms Resonrr:e <br />M-1993-059 <br />Midwestern Farms <br />March 4, 2005 <br />$688,00 ([lue on or before your anniversary date) <br />Prowcrs <br />According to C.R.S. 34-32.5-1 t6 or C.R.S. 34.32.116, each year, on the anniversary date of the permit, an of <br />_.,sbait..euhmit the. annual fee, a .repart and neap showing the extent rtf..current disturbances to affec[ed <br />reclamation accomplished to dote and during the preceding year, new disturbnnees that are anticipated f0 <br />during the upcoming year, reclanmtion that will be performed during the coming year, the dates for the beg <br />of active operations, and the dare active operations ceased for the year, if any. <br />T't..~°"8*is t~ yAYr rev"c d writ(on apnt.~) mart and snnnnt rellnr men to thl.< fnrrrr_ p(easC naie <br />udequarely labeled map shat clearly delineates and includes the above elernersrs may suffice far a written re, <br />Division records indicate the following petmittee contact inforn><~uon. Please verii'y and make any <br />changes' <br />Permittee Contact lames Ii. Kirkland <br />Pe~mittee Name: Midwestern Farms ResaurCe <br />Address: P.O. Box 580 <br />Rye, CO 81069 <br />Phone Number` (719} 4$9.3385. _ <br />Fnx Number: (719) 489.2268 <br />have additional comments and/or infomration that should he provided to the Division, plense <br />or attach it to this~f`orm along with your written report and map. Annual Repott instructions are cr <br />Owner, or Designee <br />HNll CL.t~ISTRUCTION i ECR <br />it <br />Date <br />