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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 C O L O R A D O <br />Denver, Colorado 80203 DIVISION O F <br />Phone: (303) 866 -3567 Document ImaginCVD RECLAMATIOhi <br />FAX: (303) 832 -8106 M I N I N G <br />REQUEST FOJ!'N ,_ RECEIVED - &- <br />.�.__ .11 SAFETY <br />Request for the DRMS document imp�a(g�es�ohn the folio ing DRMS Permit file(s): <br />28 2015 <br />UD`'j�Y 2) I I WDO 41 �VNttfu& WID <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 11 DVD @ $20.00 per disk <br />71 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.nuning.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 (DBMS) is not responsible and shall not be liable to the user ft <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 liabilil <br />arising out of the use of the data/information provided. <br />Customer Mailing and Contact Informat' <br />Print Name: <br />Company: �%- C,tiiY1(\Q 1'l (� . L12C• <br />Address: fJ �O_ <br />5t <br />Phc <br />Sig, <br />DRMS use only <br />CD /DVD created and <br />tested by: <br />Date: <br />V1nCe or <br />Mined land Reclamatlon Denver • Grand )unction • Durango Active and inactive Mines <br />