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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St., Room 215 <br /> Denver,Colorado 80203 C O L O RA D O <br /> Phone:(303)866-3567 D I V I S I O N o f <br /> FAX:(303)832-8106 Document Imaging CD/DVD RECLAMATION <br /> REQUEST FORM MINING <br /> SAFETY <br /> Request for the DRMS document images on the following DRMS Permit file(s): <br /> 1) ,Ll'/ - 2 0 0 _�' 2) -- l OZ0 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 a $5.00 per 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 DBMS office, online at www.rnining.state.co.us, of <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 /> l. Insert CD/DVD into your disk drive <br /> 2. 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 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 c <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 liabilit <br /> arising out of the use of the data/information provided. <br /> Customer Mailing and Contact Information: <br /> Print Name: S+e ve 0&—1 Q Yi <br /> DBMS use only <br /> ��' CD/DVD created and <br /> Company: ,ei/ tested by: <br /> Address: ce <br /> Date: —� <br /> Phone: D '(,�L.3 <br /> Signature: / <br /> Office of <br /> Office of <br /> Mined Land Reclamation Denver Grand Junction Durango Active and Inactive Mines <br /> Please pay for CD <br /> when picking up <br /> completed product <br />