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<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 ofthis application. When finished, please return this application to: <br /> <br />1lIE 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 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 />1. Name of applicant UPPER PLATTE AND BEAVER CANAL COMPANY <br /> <br />Mailing Address <br /> <br />P.O. BOX 581 <br />BRUSH, CO 80723 <br /> <br />Business Phone Number ( ) <br />Federal ill Number 84-0405195 <br /> <br />Fax Phone Number ( <br />e-mail Address <br /> <br />) <br /> <br />2. Person to contact regarding this application, if different from above: <br />Name PHILIP MORTENSEN <br /> <br />Position/Title <br />Address <br /> <br />PRESIDENT <br />P.O. BOX 581 <br /> <br />Business Phone Number ( ) <br />e-mail Addressjpm@kci.net <br /> <br />Home Phone Number (970) 842--2016 <br /> <br />3. Type of organization (Ditch Co., Irrigation District, Municipality, etc.): DITCH COMPANY <br /> <br />Date of Annual meeting FIRST MONDAY IN FEBRUARY <br /> <br />Is the organization incorporated in the State of Colorado? YES ~ NO (If YES, please <br /> <br />include a copy of the articles of incorporation, and the bylaws with this application form.) <br />ARTICLES OF INCORPORATION AND BYLAWS ON FILE WITH <br />CWCB FROM PREVIOUS LOAN <br />