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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 TECL7AMUAT <br /> O A D O <br /> Phone:(303)866-3567 t v H o f <br /> FAX:(303)832-8106 Document Imaging CD/DVD ION <br /> REQUEST FORM MINING <br /> SAFETY <br /> Request for the DRMSdocument images on the following DRMS Permit file(s): <br /> /�l-1) / 6 SJ 0 q �G / e we-K— <br /> / 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 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.lnining.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 <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 /> DRMS 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 r) 'P) r i' a Yi DRMS use only <br /> CD/DVD created and <br /> Company: tested by: <br /> Address: <br /> Atl� v Q Date! —� <br /> Phone: <br /> Signature: <br /> Office of 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 />