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STATE <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources JUL 0 5 2013 <br />1313 Sherman St., Room 215 <br />Denver, Colorado $02113 g SION OF RECLMATION a ° °, � N 0° <br />Phone: (303) 866 -3567 Document Imaging CDfD t <br />FAX: (3031 832 -$206 t> �+ 1NING AND SAFETY RECLAMATION <br />I N <br />Imo' QUES`F FORM MINING <br />SAFETY <br />ReZ-1987-143 t for the DRMS document images on the following DRI�IS hermit file(s): <br />l� , M- 1982 -020 P- 2012 -010 <br />TIte i=►vtS`tlu`tii ri irnabe �t�rcopied to eft per a or a >�lcase cck orte 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 a 55.00 per disk ')— e F C&xlq ❑ DVD @ S20.00 per disk <br />Please check if you want acopy of the Directions [or Use of CD /DVD <br />The Permit File document images can be viewed in the reception area of the DRMS office, online at wwwjnmin .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 CDMVID into your disk drive <br />/2. Click Yes to .Accept the License Agreement for Laseriiche Plus Viewer <br />4. Lasertiche will Load, Opening the Start Page <br />S. Click on the Available Repository and Click Open, You are now ready to view the files). <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 infortnation provided by the DRMS, including the installation of the data o, <br />infortnation, its use, or the results obtained from its use. Any data or information provided by the DRSNI is provided "as is' <br />without warranty of any kind, cither express or implied, including, but not limited to, the implied warranties of rrierchantabilit} <br />and fitness for a particular purpose. Data or information provided by the DItMS shall be used and relied upon only at the user' <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 datal information provided. <br />Customer Mailing and Contact Information: <br />Print Narne: <br />Company: <br />Jacob Wilkinson <br />Dunraven Mining LLC <br />Address: 510 South Wisconsin Ave <br />Gunnison, Co 81230 <br />Phone: 970 -417- 31 <br />Signature: <br />` <br />Office of <br />Nlined Lard Rerlamat;on Denver • Grand lunchon - Durango <br />DBMS use only <br />CD/DNrD creand and <br />bested Isy: <br />Date: 7— <br />Office of <br />Active and Inactive tvi, yes <br />