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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 C O L O R A D O <br />D I V IS I ON OF <br />Phone: (303) 866-3567 Document Imaging CD/DVD RECLAMATION <br />FAX: (303) 832-8106 MINING <br />REQUEST FORM -&- <br />SAFETY <br />Request for the DRMS document images on the following DRMS Permit file(s): <br />1)'/{? 3) 4) <br />4 -- f 6- <br />The DRMS ocument ifflages cyn 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 @ $5.00 per disk DVD @ $20.00 per disk <br />t/ 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 />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 n9cal van <br />2. Click Yes to Accept the License Agreement for Laserfiche Plus Viewer <br />4. Laserfiche will Load, Opening the Start Page FEB Z $ 2011 <br />5. Click on the Available Repository and Click Open, You are now ready to view the file(s). <br />Division of Reclamation, <br />DRMS cannot provide computer related support. Mining & Safety <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 DBMS, 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: d/ G L l SS?A < <j ? AJ <br />Company: CgI\S+C..?cc <br />Address: _ ? l ). ?t?C `???1 Lp CQ <br /> <br />Phone: Q? S Co ?} 2 <br />Signature: <br />Office of <br />Mined Land Reclamation Deriver • Grand Junction Durango <br />Office of <br />Active and Inactive Mines