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<br />Colorado Water <br /> <br />Conservation Board <br /> <br />Construction Fund Loan <br /> <br />Application <br /> <br />Instructions: This application should be typed or printed neatly with black ink. Attach <br />additional sheets as necessary to fully answer any question or to provide additional <br />information that would be helpful in the evaluation of this application. When finished, <br />please return this application to: <br /> <br />The Colorado Water Conservation Board <br />Attn: John W. Van Sciver <br />1580 Logan St., Suite 750 <br />Denver, CO 80203 <br />Phone Number (303) 894-2571 Fax Number (303) 894-2578 <br />e-mail: john.vansciver@state.co.us <br /> <br />Part A. - Description of the Applicant (Generally, the applicant is also the prospective <br />owner and sponsor of the proposed project. If this is not the case, please contact the <br />CWCB staffbefore completing this application.) <br /> <br />1. Name of applicant. G J '~"'- () . '-r;, ~'^--e. <br /> <br />Mailing Address _ 1175" '} 1-1 'a \oJ 'J'9 <br />S~~~w\'ck I (0 'fic'7i.f9 <br />Business Phone Number ( ~74 ) L..I '3 5707 Fax Phone Number ( ) <br />Federal ID Number e-mail Address p~~....'(.. @ 1(<.,', Y\.e. t <br />2. Person to contact regarding this application, if different from above: <br />Name <br />PositionlTitle <br />Address <br />Business Phone Number ( <br />e-mail Address <br /> <br />) <br /> <br />Home Phone Number ( <br /> <br />) <br /> <br />3. Type of organization (Ditch Co., Irrigation District, Municipality, etc. ):_ S ~ I,t <br />Date of Annual Meeting <br />Is the organization incorporated in the State of Colorado? YES _ NO <br />