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P- 6-41 <br /> t <br />4eA-7- <br /> 1 <br />AL FILE and REPORT REQUEST <br /> <br />PERMITTEE NAME: Var a Companies Inc. <br />PERMIT NO.: '?VI-2009-018 <br />OPERATION NAME: Heintzelman Project (Pit 116) <br />ANNIVERSARY DATE: June 17, 2011 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Weld <br />RECGIVNDP•1AY 3 12011 <br />Division of Reclamation, <br />Uning and Sai* <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 vour revised written annual report and annual report may to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's map are necessarv. then no new man is reauired. 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: Christ . Varr <br />Permittee Name: Varr Companies Inc. <br />Address: 8120 Gage St. <br />Frederick, CO 80516 <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 Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signs re of Corporate Officer, Owner, or Designee <br />Date <br />