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b lAl L U� LULUK�U <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 <br /> Denver,Colorado 80203 1] O I Ot o N OO <br /> Phone:(303)866-3567 Document Imaging CD/DVD RECLAMATION <br /> FAX:(303)832-8706 REQUEST FORM MINING <br /> SAFETY <br /> Request for the DRMS do1/— <br /> ent ima es on the following DRMS Permit file(s): <br /> ek <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 0 DVD @ $20.00 per disk <br /> ❑ �Se--- <br /> Please check if y ��t 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.m>ning.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 RECEIVED <br /> /4. <br /> 2. Click Yes to Accept the License Agreement for Lasertiche Plus Viewer <br /> Lasertiche will Load, Opening the Start Page , SEP 2 9 Z014 <br /> 5. Click on the Available Repository and Click Open, You are now ready to view the file(s). TION, <br /> WVIa11QN Qn5TY-MINERALS <br /> DRMS cannot provide computer related support. RAINING <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 DBMS, 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 merchantabilil <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 DBMS, 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 /> /� r•�- D � DRMS use only <br /> Print Name: /4T/I � � <br /> / CD/DVD created and <br /> Company: i�w D/'-`iEl CC, O �' r M 5tea by: <br /> Address: <br /> j�6A V z / J/�VI)f �eoate: <br /> Phone: <br /> Signature: <br /> Office of Office of <br /> Mined Land Reclamation Denver Grand)unction Durango Active and Inactive Mines <br />