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STATE OF COLOF,ADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215.' <br />Denver, Colorado 80203 <br />C O L O RA D O <br />iUN <br />Phone: (303)866-3567 Document ImagiIIg CD(DVD <br />REC ATION <br />FAX- (303) 832-B106 <br />REQUEST FORM <br />MINING <br />, &.— <br />SAFETY <br />Request for the DRMS document images on the following DRMS Permit file(s�: _ b)K,1704.0(e <br />6.) 1vL��oD 113 <br />1) ��t1�t783 �t 2)AtgDT5 3)1k1j7gA05 4) <br />The DRMS document images can be copied to either a CD or a DVD. Please c ne 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 />Lpj CD Q $5.00 per disk DVD as $20.00 per disk <br />F1Please 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,)fEce, online at www.rruning.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 />DBMS 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 foi <br />damages of any kind arising out of Elie use of data or informatidn provided by the DBMS, including the installation of the data oI <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 merchantability <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: @.� `" .- b COL` L <br />Company: <br />Address: 751 r~,'7 -.vv )t - e— [J� <br />`7 A <br />-OVLO co <br />Phone: <br />Signature:?� <br />Office of <br />Mined Land Reciamatlon <br />Denver • Grand )unction • Durango <br />DRMS use only <br />CD/DVD created and <br />tes y / <br />Date: <br />Office of <br />Active and Inactive Mines <br />