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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Mr. Keith Larson <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />U. S. Energy <br />Denver, Colorado 80203 <br />C 0L O R A D O <br />Phone: (303) 866-3567 Document Imaging CDIDVD <br />DIY IS I ON O F <br />RECLA1vtATI, N <br />FAX: (303) 832-8106 REQUEST FORM <br />MINI <br />Signature: <br />SAFETY <br />Request for the DRMS docu nt images on the following DRMS Permit file(s): <br />1) P2007 026 - 2008 052 3) 4) <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 F] DVD @ $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.rnining.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 (DRMS) is not responsible and shall not be liable to the user fol <br />damages of any kind arising out of the use of data or information 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 liabilit3 <br />arising out of the use of the data/information provided. <br />Customer Mailing and Contact Information: <br />DRMS use only <br />CD/DVD created and <br />tested by: <br />Date: <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction . Durango Active and Inactive Mines <br />Mr. Keith Larson <br />Print Name: <br />Company: <br />U. S. Energy <br />Address: <br />877 North 8th Street <br />Riverton, Wyoming <br />Phone: <br />(307) 856-9271 <br />Signature: <br />DRMS use only <br />CD/DVD created and <br />tested by: <br />Date: <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction . Durango Active and Inactive Mines <br />