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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Shelman St., Room 215 <br />Denver, Colorado 60203 <br />- ` <br />C O L O R A D O <br />v A ION Of <br />Phone: (303) 666-3567 Document Imaging CD/DVD <br />RE kMATION <br />FAX (303) 832-6106 REQUEST FORM <br />MINING <br />SAFETY <br />Request for the DBMS document images on the following DRMS Permit file(s): <br />1) Alq7 334't 2)AICO-'1D75 3)h1j7gA05 4) lA;kai�,S07 ~ <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 Q $5.00 per disk DVD Q $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.mininA.state.co.us, or <br />they can be purchased on a CD or DVD. The CD/DVD purchase cost covers the time and tabor of snaking 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 filets). <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 the use of data or informatidn provided by the DRMS, including the installation of the data of <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 merchantabilit3 <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 liabilitj <br />arising out of the use of the data/information provided. <br />Customer Mailing and Contact Information: <br />Print Name: 1-4e 1( 6 C4 -t— L <br />Company: <br />Address: 7 1 r z .►� Lf ,-�. tom: <br />G0 <br />Phone: 0 - 2, - to 3 G <br />Signature: 7N ✓ ��"�-^�"� <br />Office of <br />Mined Land Reclamation Denver • Grand )unction • Durango <br />DRMS use only <br />CD/DVD created and <br />� _ <br />t7ea <br />Date: <br />Office of <br />Active and Inactive Mines <br />