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STATE OF COLOFADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 A, <br /> Denver,Colorado 80203 C O L O R A D O <br /> D IV IS I ON Of <br /> Phone:(303)866-3567 Document Imaging CD/DVD RECLAMATION <br /> FAX:(303)832-8106 MINING <br /> REQUEST FORM —&--- <br /> SAF ETY <br /> Request for the DRMS document images on the following DRMS Permit 61e(s): <br /> 1) 2) 3) 4) <br /> If he docu¢h�r1t image Ycan be copied to either a CD or/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 Z / 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, o <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 /> 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 f <br /> damages of any kind arising out of the use of data or information provided by the DRMS, 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 i <br /> without warranty of any kind, either express or implied, including, but not limited to, the implied warranties of merchantabili <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 liabili <br /> arising out of the use of the data/information provided. <br /> Customer Mailing and Contact Information: <br /> DRMS use only <br /> Print Name: I?WiP>s iV AV& <br /> t CD/DVD created and <br /> Company: d/'fir �f�t f4�<�i F, 16l/G ° Isted by: <br /> P Y� <br /> Address: <br /> Phone: <br /> 303 - veaofL <br /> Signature: <br /> Office <br /> Office of <br /> Mined Land Reclamatl Denver Grand Junction Durango Active and Inactive Mines <br />