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<br />ill. , <br />. . <br />..'1 <br /> <br />, \ <br /> <br />COLORADO WATER CONSERVATION BOARD <br />CONSTRUCTION FUND LOAN APPLICATION <br /> <br />Instructions: This application should be typed or printed neatly with black ink. Attach additional <br />sheets as necessary to fully answer any question or to provide additional information that would be <br />helpful in the evaluation of this application. When finished, please return this application to: <br /> <br />THE COLORADO WATER CONSERV ATIONBOARD <br />Attn: John W. Van Sciver <br />1313 Sherman St., Room 721 <br />Denver, CO 80203 <br />Phone Number 303/866-3441 - Fax Number 303/866-4434 <br />e-mail: john.vansciver@state.co.us <br /> <br />Part A. - Description of the Applicant (Gem:rally, the applicant is also the prospective owner and <br />sponsor of the proposed project. If this is not the case, please contact the CWCB staff before <br />completing this application.) <br /> <br />Name of applicant: Keith Clark. President. Amity Mutual Irrhmtion Company <br /> <br />Mailing Address: P.o. Box 187. Holly. CO 81054 <br /> <br />Business Phone Number (719) 537-6627 <br />Federal ill Number: 84-0005730 <br /> <br />Fax Phone Number (719) 537-6627 <br />e-mail Address: ~ <br /> <br />2. Person to contact regarding this application, if different from above: <br />Name: Lewis Dayis <br />PositionlTitle Superintendent. Amity Mutual Irrhmtion Company <br />Address P,O. Box 390. Holly. CO 81047 <br />Business Phone Number (719 ) 537-6627 Home Phone Number ( 719 ) 537-6212 <br />e-mail Address: None <br /> <br />3. Type of organization (Ditch Co., Irrigation District, Municipality, etc. ):Ditch Company <br />Date of Annual Meeting 1st Monday in March (Next is March 4, 2002) <br />Is the organization incorporated in the State of Colorado? YES..x. NO_ (If YES, please <br />include a copy of the articles of incorporation, and the bylaws with this application fonn.) <br /> <br />4. Please provide a brief description of the owner's existing water supply facilities and describe <br />any existing operational or maintenance problems. Attach separate sheets if needed, and a <br /> <br />1 <br />