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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources` <br />1313 Sherman St., Roorn 215 odl <br />Denver, Colorado 80203 C O L D P. A D O <br />0 1VIS10N of <br />Phone; (303) 566 -3567 Document Imaging CDfDVD RECLAMATION <br />FAX (303) 932-£3146 REQUEST FORIM M I Nei — <br />j SAFETY <br />Request for the DRMS document images on the following DBMS Permit file(s): <br />4) <br />The DBMS 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 />.� CD @ $5.00 per disk 0 DVD @ $20.00 per disk <br />RPlease 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 DRMMS office, online at www.iruniii 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 />I . Insert CD/DVD into your disk drive <br />2 Click Yes to Accept the License Agreement for Laserfche Plus Viewer <br />4. Lasertiche 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 fog <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 infornation 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 liabiltt) <br />arising out of the use of the data/information provided. <br />Customer Mailing and Contact Information: <br />Print Name: mo-v -- V- Ac n <br />Company: !� ; Y ;Aa- �`'&-o -ce ;-%" <br />Address: P!O, . ISM L,523 <br />Phone: C-3cf3 �I (a 5/ --29 85 <br />Signature: _ CA A%Z:4, <br />DBMS use only <br />CD /DVD created and <br />tested by: <br />Date: <br />RECEIVES <br />�Ofhce of � Office of <br />'vtined Land Reclamation Denver • Grand )unction . Durango Inactive. Mines <br />muz I Y17*N <br />