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ANNUAL FEE and REPORT REQUEST 10 Division of Reclamation, <br />Mining & Safety <br />PERMITTEE NAME: c Midwestern Farms Resource dba Eastern Colorado Aggregates <br />PERMIT NO.: v M- 1993 -059 <br />OPERATION NAME: Midwestern Farms <br />ANNIVERSARY DATE: March 4, 2012 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Prowers <br />According to C.R.S. 34- 32.5 -116 or C.R.S. 34 -32 -116, each year, 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 annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />mp. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joe C. Baxter <br />Permittee Name: Midwestern Farms Resource dba Eastern Colorado Aggregates <br />Address: 2101 Main Street <br />Phone Number: <br />Fax Number: <br />Rye, CO 81069 <br />(719) 489 -3385 <br />(719) 489-6915 <br />AC 'RP <br />gnature of Corpora 4e Officer, Owner, or Designee <br />S3N <br />RECEIVED <br />v' (IAR c 5 20,12 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />b= • or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />