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III IIIIIIIIIIIIIIII <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br /> <br />Westhoff Farms <br />M-87-166 <br />Westhoff Farms <br />12/01/88 <br />. -~~ <br />-#:,~ - <br />. ,~ _. <br />,~ •tgi3 110 Enclosure <br />Gi.~ <br />. :.<;, <br />4L'L- <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />~' <br />Remarks: T J ~/1 ~,r" ~ ~S Ton, ' O F .n~/~`~~.'I,HC <br />~! A ~ 14 ~ l.` n , ~ h rvi ,1 U I` ~ - .- _7 J A LL'F_ 5 ~ ~-laS" <br />,rcGc ,~ ~ L ~/~l ; 7`~/ J~~ ~~ ~ s TJJF- 7 T1~L <br />l~ c 7 ~ v ~ T ~- ~, 7- ~ ~ r- s i 7 ~~ T~~r~ ~ y ~ ~ ~~. <br /> <br />s; <br />(Rev. 06/88) <br />0052f <br />