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6 STATE CIF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman$1,Room 215 OA <br /> Denver,Colorado 80203 C O L O R A D O <br /> piViSl .0t4 OF <br /> Phone:(303)866-3567 Document Imaging CDIDVD RECLAMATION <br /> FAX:(303)832-8106 M I N I N G <br /> REQUEST FORM R Mft <br /> Request for the DRMS document images on the following DRMS Permit fale(s): JUN 222016 <br /> 1) M 1977378 2) 3) 4) DPAsION OF RE,C AMATI()N <br /> MINING&SAFETy <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 tQ$5,00 per disk 1;...1 DVD @a $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.nunine.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 /> l. 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 comnuter 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 foi <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 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 liability <br /> arising out of the use of the data/information provided. <br /> Customer Mailing and Contact Information: -- <br /> Print Name; <br /> Kelsey A. Golden DBMS use only <br /> Corn an : Crowley Fleck PLLP CD VDicreated and <br /> p y <br /> Address: P.O. Box 2529 <br /> Billings, MT 59103-2529 Date: <br /> Phone; (406) 255-7273 <br /> Signature: <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand Junction Durango Active and Inactive Mines <br />