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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 C O L O R A D O <br />Phone: (303) 866 -3567 Document Imaging in g CD/DVD RECLAMATION Ss 1 0 N <br />FAX: (303) 832 -8106 <br />REQUEST FORM MINING <br />SAFETY <br />Request for the DRMS document images on the following DRMS Permit file(s): <br />1) ?--z 3) 4) <br />;!S � &-lb" � ,y <br />�e RMS document images can be copied ©W as CD or a DVD. Please check one below and return <br />this form with your payment to DRMS. If a CD is requested and the permit is too large for a CD, you will be called. <br />NO e-4-4"G-hr <br />CD (x-46 ^^ per 4i-a � _ DVD @ $20.00 per disk <br />Please check if you want a copy of the Directions for Use of CD /DVD <br />The Permit File document images can be viewed in the reception area of the DRMS office, online at www.inining.state.co.0 , or <br />they can be purchased on a CD or DVD. The CD /DVD purchase cost covers the time and labor of making the CD/DVD. <br />asic Instructions: <br />1. Insert CD /DVD into your disk drive <br />2. Click Yes to Accept the License Agreement for Laserfiche Plus Viewer <br />4. Laserfiche will Load, Opening the Start Page <br />5. Click on the Available Repository and Click Open, You are now ready to view the file(s). <br />DBMS cannot provide computer related support <br />Disclaimer: <br />The Colorado Division of Reclamation, Mining and Safety (DRMS) is not responsible and shall not be liable to the user ft <br />damages of any kind arising out of the use of data or information provided by the DBMS, including the installation of the data ( <br />information, its use, or the results obtained from its use. Any data or information provided by the DRSM is provided "as is <br />without warranty of any kind, either express or implied, including, but not limited to, the implied warranties of merchantabilit <br />and fitness for a particular purpose. Data or information provided by the DRMS shall be used and relied upon only at the user' <br />sole risk, and the user agrees to indemnify and hold harmless the DBMS, its officials, officers and employees from any liabilit <br />arising out of the use of the data/information provided. <br />Customer Mailing and Contact Information <br />Print Name: ,")W a r d `)u n /I DRMS use only <br />��r-- CD/DVD created and <br />Company: Prl C $ G i7 4ee r � /j ted by: <br />Address: �S� C r___14__ <br />e.Z Date /�� <br />Phone: C <br />,mgnature: <br />Office of <br />Mined Land Reclamation Denver •Grand )unction •Durango Office of <br />Active and Inactive Mines <br />