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I) List attached2) <br />Print Name: <br />Company: <br />Address: <br />Phone: <br />Signature: <br />i / <br />- oo 1 — 0 61 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 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />Request for the DRMS document images on the follOWing.pRivis Permit file(S): <br />DRMS cannot provide computer coinputer related support, <br />Customer Mailing and Contact Information: <br />Charles 2 . Forster <br />Forster Engineerinct <br />19915 Wit teriburg <br />San Antonio, TX 78256 <br />210 ) 698-5544 <br />Charles P Forster <br />Document Imaging CD/DVD <br />REQUEST FORM <br />3) 4) <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 C'D S5.00 per disk I) <br />DVD S20,00 per disk <br />X Please check if you want a copy ofthe.Directioiis 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.rnining.state.co.us, or <br />they can be purchased on a CD or DVD. The CINDVD purchase cost covers the time and labort3f making the CD/DVD. <br />Basic Instructions: <br />Insert CD/DVD into your disk dtive <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 new ready to view the file(s). <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 wan 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 DRINAS, its officiaLs, officers and employees from any liability <br />arising out of the use of the data/information provided. <br />+vaned Land Reclamation Denver • Grand junction • Durango <br />t <br />RECEIV <br />JUL 2120 <br />R A D 0 <br />1510N 0 <br />RECLAMATION <br />Division of Reciamal onM:INING <br />Mining & Safety' —SAFGtET—Y <br />CD/DVD created and <br />steel by: <br />Office of Office of <br />Active and Inactive Mines <br />CLI <br />/ ;,..4 <br />