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ti -d <br />~~'~~d e <br />N0.821 <br />5 <br />PERMlT1'EE NAME: Midwestern Farms Resource <br />PERMIT NO.: M-1993-059 F~B 2 % 2QQij <br />OPERATION NAME: MidwcsternFarms ~ivisionoiMinerals <br />and aeoloo~ <br />ANNNERSARY DATE: Marcb 4, 2004 <br />ANNUM- FfE DUE: $688.00 (Due oa or before your anniversary date) <br />COUNTY: Prowcrs <br />According to C.R.S. 34-32.5-1 ] 6 or C.R.S. 34-32-1 IG, each year, on d1e anniversary date of the permit, an op <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affa[ed <br />reclamarion accomp]ished to date and during the preceding year, new disturbances [hat are anticipated to <br />during the upcoming year, reclamation that will 6e performed during the coming year, the dates fur the beg <br />of active operarions, and the date octive operations ceased for [he year, if any. <br />i')rnce attvrh ~n r~ r rrvicr 1 writt n nnpal rgRar[~annunl r[. nr~~ja [hlc prm PJeaS¢ nOIC tJ~af <br />ade9uarely labeled map shat clearly delirteafes and Jnclades the above eJe+nents may sufficefor a written report. <br />Division records indicate the following permittee contact infomration. Ple<~se verify and make any <br />changes: <br />Permittce Contact: James J,1. Kirkland <br />Permitter Name: Midwestern Farms Resource <br />Address: P. O. Dox 560 <br />Phone Number: <br />Fax Number: <br />Rye, CO 8)069 <br />(719) 489-3385 <br />{719) 469-22G8 <br />Jf you have additional comments and/or information that shoald be provided to the Division, please provi it <br />w or attach it to this form along with your written repon and map. Annual Report instructions are enclosed <br />igna[ure of Corp rate Ofticer, Owner, or Dcsipiee <br />a~ o <br />Date <br />LDO~ <br />- \, V <br />