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�rm /987"%V <br />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 />COLORADO <br />Phone: (303) 866-3567 <br />Document Imaging �f DVD <br />RECLAM D I V I S I O N ATI O F <br />ON <br />FAX: (303) 832-8106 <br />RIi.�T FORM <br />ING <br />Request for the DRMS document images on the following DRMS Permit file(s): APR 3 0 Z0 1Z <br />1) M 9 H S 03 / <br />2) Ig if _ 3) / " ` (` I —G 4) @IYIs19Fi of Reclamation, — <br />Cup Mining & Safety <br />Mo o In Sod ,4et^ Luc l� <br />The DRMS %do m eniiages can be copied to either a CD or a DVD. Please �(o eck one below d return <br />this form with your payment to DRMS. If a CD is requested and the permit is large for a CD, you will be called. <br />CD @ $5.00 per disk _ DVD @ $20.00 per disk <br />CTr,,o o: <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.iuiniiiq.state.ca.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 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: ll <br />Print Name: J CU �% l L k l >J SG /� <br />Company: M ,:\l So�,Fn- C is Pr <br />Address: <br />(iuNu ;Soli Cli. �t J-�® <br />Phone: �% J <br />Signature: c. Ai( <br />DRMS use only <br />CD/DVD eated and <br />sted by: <br />Date: <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />