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-r, /'r <br />ANNiiAi. FF.F and RF,PnRT RF.~iTFST <br />PERMITTEE NAME: ~W thoff Farms <br />PERMIT NO.: M-1987-166 <br />OPERATION NAME: Westhoff Farms <br />C~7/Yf <br />RECEI'VE~ <br />DEC 012005 <br />Division oI Minerals and Geology <br />ANNNERSARY DATE: December 1, 2005 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Morgan <br /> <br />A - - .6_nr~.ILS t4_1~_I 16,yach vear on the anniversary date of the permit an operator ~ <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written anmral repo and ann .al rennrt manrtn thix form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joseph E. Westhoff <br />PermitteeName: Westhoff Farms <br />Address: 2823 RD3 <br />Wiggins, CO 80654 <br />Phone Number: (970) 483-5561 <br />Pax Number: (970) 483-5561 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Sf~mature of Corpor>at~~ellOl'ficefrCSwner, or Designee <br />~~~~~/ V <br />Date ~ <br />