2017-06-08_REPORT - M1984036

• Permit No: M1984036
• IBM Index Class Name: REPORT
• Doc Date: 6/8/2017
• Doc Name Note: Annual Fee and Map
• Doc Name: Annual Fee/Report/Map
• From: Varra Companies, Inc.
• To: DRMS
• Annual Report Year: 2017
• Email Name: PSH
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have
information on record). If this information is blank or not current,please type or print current contact information:
Permittee Contact: Christopher L.Varra
Permittee Company: Varra Companies,Inc.
Address: 8120 Gage St.
Frederick, CO 80516
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Permitting Contact: Bradford Janes
Compan}l: Varra Companies,Inc./Office of '
Special Projects
Address: 8120 Gage Street
Frederick,CO 80516
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Christopher L.Varra
Company: Varra Companies,Inc.
Address: 8120 Gage Street
Frederick,CO 80516 �0 v
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Phone Number: [phone] .� i v ,rZ
Fax Number: [phone]
Email Address: -1�Y•
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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.
Signature of Permittee,Corporate Officer,Owner,,oi•� mented Designee Date
M-AF-O] E �� \\
JUN 2 0 2017
, i• AmATION,
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