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<br />CWCB Construction Fund Loan Application <br /> <br />T ,enrler N~me & Arlrlress <br /> <br />Remaining <br />Amount <br /> <br />Annual <br />Payment <br /> <br />Maturity <br />n~te <br /> <br />(None) <br /> <br />2. Are any of the above liabilities now in default, or been in default at any time in the past? YES_ <br />NO _' 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.). Tn the pl'lst two nscl'll years the priml'lry <br />source of revenlles h~ve heen l'lssessments ($11 O/sh~re X 2fi:S shl'lres = $'7.9,1 :SO/yp.l'lr) pIllS l'l few <br />rlitch crossine fees ~t $4:S0/el'l ~11 totl'lline l'lhollt $10,000 per yp.l'lr <br /> <br />4. Please provide a brief narrative description of sources of funding, in addition to the CWCB, which <br />have been explored for this project (Examples would be Banks, Rural Development, NRCS, <br />Colorado Water Resources and Power Development Authority, Colorado Division of Local <br />Government, etc.). (None l'lt this time) <br /> <br />5. What collateral will you be offering for this loan? Possibilities include the project itself: pledge of <br />revenues, real estate, water rights. The Project <br /> <br />The above statements are true, to the best of my knowledge: <br /> <br />Signature ~lApplic'4t 1- \ " n <br />By ~LW~~~t~ <br /> <br />Printed Name John Whitesirle <br /> <br />Title Presirlent <br />Date \ 7 -/-0 ~ 7. <br /> <br />C:\Projects\Market\CHA602 <br /> <br />4 <br /> <br />CFLA602 <br />