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ANNTiAi. FF.F, and RF.Pt7RT RF.[)iTF.ST I~~%// /i <br />PERMITTEE NAME: Varra Companies, Inc. / '' <br />PERMPf NO.: M-1980-002 ~Q~I~~ Q i ;"~sJ <br />OPERATION NAME: Tucker Aggregate Pit , . ~~ , <br />ANNNERSARY DATE: June 1, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Weld <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 ynnr revised written annnal report and anm~al report man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a writte~z 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: 8120 Gage St. <br />Frederick, CO 80516 <br />Phone Number: (303) 666-6657 <br />Fax Number: (303) 666-6657 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below o/r a//t~tach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signa of Corporate Officer, Owner, or Designee <br />1 June 2005 <br />Date <br />