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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY �o },� o4<„rj(4 <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 C O L O R A D O <br />D I M S I O N OF <br />Phone: (303) 67 Document Imaging CD/DVD RECLAMATION <br />FAX: (303) 832 -8102 -810 6 gE UEST FORM MINING <br />SAFETY <br />Rst for the DRMS document images on the following DRMS Permit file(s): <br />Z 1) 1989056 2) 3) 4) <br />.Dar /1 ,d- ca %i 41 6K �1 <br />The D S ocument Images caTitSe copied to ett er a D or VD. 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 />7 � CD @ $5.00 per disk 0 DVD @ $20.00 per disk <br />Please check if you want a copy of the Directions for Use of CD /DVD <br />The Permit Nile document images can be viewed in the reception area of the DRMS office, online at www.nllning,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 D <br />2. Click Yes to Accept the License Agreement for Laserfiche Plus Viewer RECEIVED <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). NnV O 3 2014 <br />DRMS cannot provide computer related support. <br />DIVISION OF RECLAMATION <br />Disclaimer: <br />MINING AND SAFETY <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 DBMS 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: Michelle Johnson <br />Company: Martin and Wood Water Consultants IF <br />Address: 538 Commons Drive <br />Golden, CO 80401 <br />Phone: 720 - 836 -6569 <br />DRMS use only <br />CD/DVD created and <br />tAsted by: n <br />Signature: 1'��;G�C(1 t �t.,• , <br />Please make 2 CD copies of the permit file @ $10 and mail to address above. <br />Office of Office of <br />Mined Land Reclamation Denver • Grand }unction • Durango Active and Inactive Mines <br />