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b IAI E Ur LULUK�U <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources �A V� <br /> 1313 Sherman St.,Room 215 Yl U <br /> Denver,Colorado 80203 C O L O R A D O <br /> DIVIS 10 N O F <br /> Phone:(303)866-3567 Document Imaging CD/DVD RECLAMATION <br /> FAX:(303)832-8706 QUEST FORM MI ING <br /> SAF ETY <br /> Request for the DRMS docu ent ima es on the following DRMS Permit file(s): <br /> 1) 2) 3) 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 /> CD @$5.00 per disk V4 ❑ DVD @ $20.00 per disk <br /> Please check if ydru 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.rnrninR.state.co.us, or <br /> they can be purchased on a CD or DVD. The CD/DVD purchase cost covers the tirme and labor of making the CD/DVD. <br /> Basic Instructions: <br /> l. Insert CD/DVD into your disk drive RECEIVED <br /> /2 Click Yes to Accept the License Agreement for Lasertiche Plus Viewer I� <br /> 4. Lasertiche will Load, Opening the Start Page , SEP z 9 ZO14 <br /> 5. Click on the Available Repository and Click Open, You are now ready to view the file(s). <br /> pIVISIQa Q1LFaTy-MINETIRO, <br /> DBMS cannot provide commuter related support. M1l11NGi 8 , <br /> Disclaimer: <br /> The Colorado Division of Reclamation, Mining and Safety (DRMS) is not responsible and shall not be liable to the user fc <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 mercharitabilit <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 liabilil <br /> arising out of the use of the data/information provided. <br /> Customer Mailing and Contact Information: <br /> DRMS use only <br /> Print Name: 147-4 4!LY //�V L , '07 A9/, 7 <br /> CD/DVD created and <br /> Company: 21WD/`r/ 0 �' r�-� M IL 5t�a(I by: <br /> Address: 1,Ls l I - <br /> S Ll -) 0 <br /> 6/V V� G VI).f �QO ate: <br /> Phone. r <br /> 0 3— as <br /> Signature: <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand)unction • Durango Active and Inactive Mines <br />