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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 />Phone: (303) 866-3567 D T V I s I D N o f <br />FAX: (303) 832-8106 Document Imaging CD/DVD RECLAMATION <br />REQUEST FORM MINING <br />SAFETY <br />Request for the DRMS document images on the folioyring DRMS Permit file(s),: <br />1) I'y?/?78-212U(? 'Zoo8-oi 3) ??P-2007-657 4) f1- /p77-?-?3 <br />nob-OSc? ?) ' P-2008-053 <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 />X CD @ $5.00 per disk _ DVD @ $20.00 per disk <br />Please check if you want a copy of the Directions for Use of CD/DVD <br />-XI The Permit File document images can be viewed in the reception area of the DRMS office, online at www.mining.state.co.us, or <br />they can be purchased on a CD or DVD. The CD/DVD purchase cost covers the time and labor of making the CD/DVD. <br />Basic Instructions: <br />1. Insert CD/DVD into your disk drive <br />2. Click Yes to Accept the License Agreement for Laserfiche Plus Vie.z er <br />4. Laserfiche will Load, Opening the Start Page <br />5. Click on the Available Repository and Click Open, You are now ready to view the file(s). <br />DBMS cannot provide computer related support <br />Disclaimer: <br />The Colorado Division of Reclamation, Mining and Safety (DRMS) is not responsible and shall not be liable to the user for <br />damages of any kind arising out of the use of data or information provided by the DRMS, including the installation of the data or <br />information, its use, or the results obtained from its use. Any data or information provided by the DRSM is provided "as is" <br />without warranty of any kind, either express or implied, including, but not limited to, the implied warranties of merchantability <br />and fitness for a particular purpose. Data or information provided by the DRMS shall be used and relied upon only at the user's <br />sole risk, and the user agrees to indemnify and hold harmless the DRMS, its officials, officers and employees from any liability <br />arising out of the use of the data/information provided. <br />Customer Mailing and Contact Information: <br />Print Name: ?pro L S 21 LA I DBMS use only <br />Company: Ns U T EA C-0I u- C es dby create-tc a <br />I y; <br />Address: 6 5o W N 1, Si3 A\j t A$k <br />T O O LDW . Ce) kb K6 4, Date: 3j -11 <br />Phone: ?b3 443 10 (S fo <br />Signature: a-ow <br />(JO <br />Office of Office of <br />Mined Land Reclamation Denver • Grand )unction • Durango Active and Inactive Mines