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IIIIIIIIIIII �zY4 <br /> III IIII 999 <br /> ANNUAL FEE and REPORT REQUEST Eccj J/Ej <br /> PERMITTEE NAME: Varra Companies,Inc. UN Q f 2001 <br /> Qin'siaa <br /> PERMIT NO.: M-1984-036 t Minerals and Ceala9Y <br /> OPERATION NAME: Dakolios Pit No. 1 <br /> ANNIVERSARY DATE: June 1,2001 <br /> ANNUAL FEE DUE: $550.00(Due on or before your anniversary date) <br /> COUNTY: Weld <br /> According to C.R.S. 34-32.5-1 l6 or C.R.S. 34-32-116, each year, on the anniversary da a of the permit, an <br /> operator shall submit the annual fee, a report and map showing the extent of current dist rbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances t t are anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming y r, the dates for the <br /> beginning 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. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may uffrce for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Christopher L. Varra <br /> Permittee Name: Varra Companies, Inc. <br /> Address: 12910 WCR 13 <br /> Longmont,CO 80504 <br /> Phone Number: (303) 666-6657 <br /> Fax Number: (303) 666-6743 <br /> If you have additional comments and/or information that should be provided to the Divi on, please provide it <br /> below or attach it to this form along with your written report and map. Annual R port instructions are <br /> enclosed. <br /> 14�— <br /> Signature/Corporate Officer or Owner <br /> Date <br /> M\PERA7ITTMASTERDOCUAENTSVM-AF-01 <br />