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<br />ANNUAL REPORT <br />• iii iiiiiiriiiiii iii <br />'~ECEI VED <br />IJE I: C g jn,9 <br />PERMITTEE NAME: Westhoff Farms <br />PERMIT NO.: M-87-166 <br />OPERATION NAME: Westhoff Farms <br />ANNIVERSARY DATE: December Ol, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 <br />COUNTY: Morgan <br />Division of Minerab s Geolo9Y <br />1'AI~J <br />According to C.R.S. 34-32.5-1 16(3)(a), each year, on the anniversazy date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during [he upcoming year, reclamation that will be performed during [he coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that nn ndequntely labeled rnnp that clear[v delinentes aid includes the above elements may <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: ~"1 ' g 7 - ~ is <br />Adddress: ~ ~i ~ ~ f4 ,h .~ <br />Gv fGG//t5 L'~,J tC ~G ~'z/ <br />Company: (it/ F ~ ~N ~I' F ~~ ~ lV' S <br />Phone No.: (~ ~~ `} ~ ~-S S ~ <br />FaxNo.:(`j7J) ~~~-SAG/ <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />~ ~ ~ r! <br />Signature of Corporate Officer, o Owner Date <br />INSTRUCTIONS ON BACK <br />