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DIVISION OF RECLAMATION, MINING AND SAFEW <br />Department of Natural Resources <br />1313 Sherman St., Roam 215 04 <br />Denver, Colorado 80203 �COL OPADO <br />Phone: (3031866-3567 DIVIiS TON OF <br />Document Imaging CD/DVD ij RECLAMATION <br />FAX: (303) 832-8106 REQUEST F70 M MINING <br />Y <br />S 7 <br />V/ AFYTY <br />Request for the DRMS document images on the following DRMS Permit file(s): <br />1) <br />M2006018 <br />2) <br />M1996082 <br />.3) M2010058 4.).M1980136 <br />The DR-MS document images can be copied to either a 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 />W-1 CD @ $5.00 per disk L] DVD @ $20.00 per dis':1-1 <br />F-1 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 DRUMS office, online at or <br />they can be purchased on a CD or DVD. The Cl)/DVD purchase cost covers the time and labor of making the CD/L)VD. <br />Basic Instructions: <br />1. Insert CD/DVD into your disk drive <br />2, <br />4. LA � jdq, 0 enin <br />_-p ---- e <br />5. You are now ready to view the file(s). <br />DRMS 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 foi <br />damages of any kind arising out of the use of data or informati6n provided by the DRMS, including the installation of the data of <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 rnercliantabilit) <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 DRMS, its officials, officers and employees from any liabilit3 <br />arising out of the use of the data/information provided, <br />Customer Mailing and Contact Information: <br />Print Name: <br />Genevieve Blecha <br />Company: <br />01dicastle SW Group, Inc. <br />Address: <br />2273 River Road <br />Grand Junction, CO 81505 <br />Phone: <br />970-243-4900 <br />Signature: <br />6 4�� <br />office of <br />Mined Land Reclamation Denver • Grand Junction • Durango <br />l2 X 3013 <br />vo� <br />DRMS use only <br />CD/DVD created and <br />tested by. <br />Date: lgbdI42 <br />Off-ce of <br />Active and Inactive Mines <br />