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STATE OF COLOKADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St„ Room 215 <br />Denver, Colorado 60203 COLORADO <br />D I V I S I O N OF <br />Phone: (303) 866 -3567 Document Imaging CDIDVD RECLAMATION <br />FAX: (303) 832.8706 MINING <br />REQUEST FORM — &- <br />SAT-ETY <br />Request for the DRMS document images on the following DRMS Permit file(s): <br />3) <br />4) <br />The DRMS 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 />Cc $5A "r disk 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.nuning.state.co,us, 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 />Basic 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. Laserliche will Load, Opening the Start Page <br />5. Click on tine Available Repository and Click Open, 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 forn <br />damages of any kind arising out of the use of data or information 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 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 DRMS, its officials, officers and employees from any liability <br />arising out of the use of the data /information provided. <br />Customer Mailing and Contact Information: <br />DRMS use only <br />Print Name: ;�.1�_t..o.._. <br />r CA UF CD /DVD created and <br />Company: tested by. <br />�Address: cfC � <br />�► / c. <br />a <br />Phone: 13� 3 I <br />Signature: <br />4Office of µ z � Office of <br />Mined Land Reclamation Denver Grand Junction Durango Active and Inactive Mines <br />