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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY 14 I/-/ V _ r/ <br />Department of Natural Resources 7 444 <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 C O L O R A D O <br />Phone: (303) 866-3567 D I V 15 10 N o f <br />Document Imaging CD/DVD RECLAMATION <br />FAX: (303) 832-8106 REQUEST FORM MI&- <br />SAF ETY <br />equest for the DBMS doc ment images on the foil wing DBMS Permit file(s): <br />1) r G? 2) ?i`6? 3 q ©?? 4) <br />(G -S? --? <br />C?Th DBMS document ima ??ne pler to 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 @ $5.00 per disk _ DVD @ $20.00 per disk <br />Please check if you want a copy of the Directions for Use of CD/DVD <br />The Permit File document images can be viewed in the reception area of the DRMS office, online at www.mining..state.co.us, or <br />Zasi canbe purchased on a CD or DVD. The CD/DVD purchase cost covers the time and labor of making the CD/DVD. <br />c Instructions: <br />1. Insert CD/DVD into your disk drive <br />2. Click Yes to Accept the License Agreement for Laserfche Plus Viewer <br />4. Laserfiche will Load, Opening the Start Page <br />5. Click on the Available Repository and Click Open, You are now ready to view the file(s). <br />DRMS cannot provide computer related support. <br />Disclaimer: <br />The Colorado Division of Reclamation, Mining and Safety (DRMS) is not responsible and shall not be liable to the user for <br />damages of any kind arising out of the use of data or information provided by the DRMS, including the installation of the data or <br />information, its use, or the results obtained from its use. Any data or information provided by the DRSM is provided "as is" <br />without warranty of any kind, either express or implied, including, but not limited to, the implied warranties of merchantability <br />and fitness for a particular purpose. Data or information provided by the DRMS shall be used and relied upon only at the user's <br />sole risk, and the user agrees to indemnify and hold harmless the DRMS, its officials, officers and employees from any liability <br />arising out of the use of the data/information provided. <br />Customer Mailing and Contact Information: <br />Print Name: tev e- M$ Me <br />Company: <br />Address: <br />CA 1 l,? s Co ?;?S?y <br />Phone: L7 <br />Signature: <br />Office of <br />Mined Land Reclamation Denver Grand Junction Durango <br />DRMS use only <br />CD/DVD created and <br />tfsted by: <br />` _0 yw <br />Office of <br />Active and Inactive Mines