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�,&5 <br />STATE OF COLORADO <br />DIVISION Op RECLAMATION, MINING AND SAFETY <br />oenamv"o"'m Natural Resources <br />13 `3 s/.=".""u'mmrn2 15 <br />Denver, Colorado 80203 ~ ° ^ ° * u u <br />p�n,.'»»oa6o�se &Vm�mmm�oxV ��m� ^�� �����0���� ' | <br />p�x�ouz>mz�,no � | <br />��]�������S1�Xz���&�� '`^^^ <br />SAFETY <br />Request for the QBMS doct es on the /b}|owlug DBMS Permit O}c(o): � <br />M1977439 051 <br />The DRMS document images omh: copied w either xCDmuDVD. Bedsucheck one below and return <br />thl� 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 />�� �� <br />�y | CD��S5.U0 per disk L~~] DVDCq,) $2OD0 per disk <br />7 Please check if you want a copy of the Directions for Use ofC D/DVD <br />The Permit File document images can be viewed in the reception area of the DRMSmffice, online at or <br />they can hc purchased ouaCDo,DVD. The C[VDVD purchase cost covers the time and labor o{making thoCD/DVD. <br />Basic Instructions <br />| Insert CID/DV Din( ci your disk drive <br />2 Click Yes ^` Accept the License Agreement for Lus*r5chc Plus Viewer <br />4� Lu*er6cbew|U L*od, Opening [tic 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 />Dixclunec <br />The Colorado Division ofReclamation, &4u6ng and Safety (DBNI8) is not responsible and abo| not be liable to the user bm <br />damages of any kind arising out of the useof data or inforinati6n provided by the DIRMS, including the installation of the data u/ <br />infonna,iou, its use, or the results obtained from its use. ,Iu'y data oriuOnnnutioo provided by tbeQfl801 is provided "as is' <br />without warranty ofany kind, either express or implied, including, but not limited to, the implied warranties of rnerchantabilit3 <br />and Otuewn for x pauiuu}a,purpoue Data or information provided by d`cDDMS nhoU be used and relied upon only at the user',, <br />sole risk, and the user agrees to iudnnmi[y and hold harmless the DR*\S, its officials, offiocm and employees from any liabi}ii\ <br />arising out ofthe use ofthe data/information provided, <br />Custom*rKluUing and Contact Information: <br />��r����Q���[ls <br />Print ��a/no� ^-� ' Stephens <br />' <br />�`'fx of ������|f�� <br />C"n�aoy� ~~^^� ~' Greeley <br />1 �y1�� ���f� <br />A`dJ�yx� ' `"~^ "°"' ~^=ee~ <br />Suite ��H <br />��^°� ~^�� <br />970-350-9812 <br />�igu/uoo� <br />om` of <br />,�,Iinecj Land Reclamation Denver Grand junction - Duiiingo <br />CD/DVD created and <br />tested by: <br />Dxtm` <br />Office of <br />Active and Inactive Mines <br />