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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 60203 COLORADO <br />Phone: (303) 666-3567 Document Imaging CD/DVD RE v'CUMATION <br />FAX (303) 832-8106 REQUEST FORM MINING G <br />SAFETY <br />Request for the DRMS document images on the follo M�S Permit file(s): P",' D04- O ( e <br />1) A-1978 4S 2) A1q 7j D- 1kl`i7q),05 4) tip AcX>5 D75 <br />The DRMS document images can be copied to eith�r-a-CD or a DVD. Please check one below and return <br />this form with your payment to DRMS, 1f a CD is requested and the permit is too large for a CD, you will be called. <br />CD lit $5.00 per disk DVD Q $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.rruning.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 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 foi <br />damages of any kind arising out of the use of data or information provided by the DRMS, including the installation of the data of <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 DBMS shall be used and relied upon only at the user': <br />sole risk, and the user agrees to indemnify and hold harmless the DBMS, 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: '�_ 6 ��c L <br />Company: i t'ay_o <br />Address: r751 or•,'2.o <br />6� ►n. <br />r-" 4 N+�cr 'wi G c7 �t S fl <br />Phone: t? !o <br />Signature: <br />DRMS use only <br />CD/DVD created and <br />tes y: / <br />Dater <br />Office of Office of <br />Mined Land Reclamation Denver • Grand )unction • Durango Active and Inactive Mines <br />