2015-08-03_REPORT - M2010049

• Permit No: M2010049
• IBM Index Class Name: Report
• Doc Date: 8/3/2015
• Doc Name: Annual Fee, Report and Map
• From: Varra Companies, Inc.
• To: DRMS
• Email Name: PSH
• Media Type: D
• Archive: No

Page 5 of 5
Address: 8120 Gage St.
Frederick, CO 80516
Phone Number: 303) 666-6657
Fax Number:
Email Address: CF.PR.email
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.
4w' 7,
of Permittee, Corporate Officer, Owner, or Documented Designee Date