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~~` i <br />..` <br />110 and 111 Enclosure <br />Permittee Name: Varra C~ Inc <br />Permit No: M-81-22E_ <br />Operation Name: Gravel Plant No 3 <br />Anniversary Date: 17 ~ 13 ~ 85 <br />Please complete the fol?owing and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Chec*fc space(s) below) <br />Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Remarks: <br />'~ D <br />f/Z <br /> <br /> <br />~~ <br />.' <br />• ~J <br />Signa <br />