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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />STATE OF COLORADO <br />1313 Sherman 5t., Room 215 <br />COLORADO <br />Denver, Colorado 80303 otvtstaN OF <br />Phone: 13031 666-3567 Document Ima& VD RECI.A&tATION <br />FAX: (303) 632.6106 MININREQUEST FORM ECED sA G <br />TYE <br />60'222017 <br />V-Aequest for the DBMS document images on the following DRMS Permit file(s): <br />M94-005 DIVISION OF RECLAMATION <br />I } a 2) 3) 4) _ -MINI tr AND 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 DBMS. If a CD is requested and the permit is too large for a CD, you will be called. <br />CD r@ $5.00 per disk F-1 DVD Q $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 office, 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 />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 />DRMS cannot nrovide computer related supipart. <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 rnerchantabilita <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 DBMS, 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: John Kuijvenhoven <br />Company: Uncompahgre Holdings LLC <br />Address: 6124 County Rd 5 <br />Ridgway, CO 81432 <br />Phone: <br />970 417- <br />Signature: <br />DRMS use only <br />CD/DVD created and tested by, <br />Michelle S. Ramirez <br />Program Assistant <br />303-866-3567 x8114 <br />August 22, 2017 <br />Office of Oif ice of <br />tinned Land Reclamation Denver - Grand Junction - Durango Active and Inactive Mines <br />