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<br />CWCB Construction Fund Loan Application <br /> <br />Lender Name & Address <br />CWCB (loan #C150015) <br /> <br />Remaining <br />Amount <br /> <br />Annual <br />Payment <br /> <br />Maturity <br />Date <br /> <br />$130,524.92 <br /> <br />60,143.30 <br /> <br />2. Are any of the above liabilities now in default, or been in default at any time in the past? <br />YES_ NO -L-. If YES, please give detailed explanation. <br /> <br />3. Please provide a summary of all revenues received during the last two fiscal years by category <br />(such as service charges, tap fees, assessments, etc.). <br /> <br />Please see attached financial statements for 2003 and 2002. <br /> <br />4. Please provide a brief narrative description of sources of funding, in addition to the CWCB, <br />which have been explored for this project (Examples would be Banks, Rural Development, <br />NRCS, Colorado Water Resources and Power Development Authority, Colorado Division of <br />LocalGovemment,etc.). Not aware of any other sources of funding. <br /> <br />5. What collateral will you be offering for this loan? Possibilities include the project itself, pledge <br />of revenues, real estate, water rights. \.1 e co U 1 d g i ve you a p 1 e d 9 e 0 f the <br /> <br />Ditch Assessment-Revenues and the project we are by.ildino. <br /> <br />The above statements are true, to the best of my knowledge: <br />Signature of Applicant <br />By (t\~(Ir-{J- .2c1~ <br />Printed Name -R Cl 16 ~ 'R .., S>r /.) '-- A G b. t... <br />Titletf( b.. S" l D,;;; /J I <br />Date ~ t 3 -:L 0'-0 c..1 <br />-er I -i <br /> <br />C:\Projects\Market\CFl..A902 <br /> <br />4 <br /> <br />CFlA902 <br />