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<br />Water Supply Reserve Account - Grant Application Form <br /> <br />Form Revised October 2006 <br /> <br />Part A. - Description of the Applicant (Project Sponsor or Owner); <br /> <br />1. Applicant Name(s): Basalt Water Conservancy District <br />Art Bowles, President <br /> <br />Mailing address: <br /> <br />P.O. Box 974 <br />Glenwood Springs, CO 81623 <br /> <br />Taxpayer ID#: , 84-1014102 <br />Phone Numbers: Business: <br />Home: <br /> <br />Email address: <br /> <br />I bowles563@comcast.net <br /> <br />I <br />I <br />I <br /> <br />Fax: <br /> <br />970-945-6777 <br />970-927 -9635 <br />970-945-1137 <br /> <br />2. Person to contact regarding this application if different from above: <br /> <br />Name: <br /> <br />Eric Mangeot <br /> <br />l <br />I <br /> <br />Position/Title <br /> <br />Water Resources Engineer <br /> <br />3. Provide a brief description of your organization below: Refer to Part 2 of criteria and guidance for required <br />Information. Attach additional sheet(s) as needed. <br /> <br />I Please See Attached Page 11. <br /> <br />2 <br />