PROJC01841 ‎(2)‎

• Contract/PO #: C150270
• Contractor Name: Headgate 135 Lateral, Inc.
• Contract Type: Loan
• Water District: 0
• County: Mesa
• Loan Projects - Doc Type: Feasibility Study

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COLORADO WATER CONSERVATION BOARD
CONSTRUCTION FUND LOAN APPLICATION

Instructions: This application should be typed or printed neatly with black ink. Attach additional
sheets as necessary to fully answer any question or to provide additional information that would be
helpful in the evaluation of this application. When finished, please return. this application to:

THE COLORADO WATER CONSERVATION BOARD
Attn: Water Supply Planning and Finance Section - Loans
1313 Sherman St., Room 721
Denver, CO 80203
Phone Number 303/866-3449 - Fax Number 303/866-4474
e-mail: [e-mail]

Part A. - Description of the Applicant (Generally, the applicant is also the prospective owner and
sponsor of the proposed project. If this is not the case, please contact the CWCB staff before
completing this application.)
1. Name of applicanJ-l~ ~~~fl ~e- I 35 Lo.... + i2 r a I. / MC- .

Mailing Address 3D 4 .;;I. ~/ ~ r de+-
Gr()...nd J'LAt1c+io__ Co'll 50C/-

Business Phone Number (l7D ) ~0 0 - q 583 Fax Phone Number (crJD) ~~3 - 5 C;; 7- cr
FederalIDNumber ~ 1CX'(ldo Y)0f\ - e_mailAddressY.rlClf.5ha._bCLf.ke.r }
'f(,D{-~-\- Cor po ('CCt"LO() b.e $f1 ail. /}e
2. Person to contact regarding this application:
Name &ordol\ ~Ovr Q.-V'
Position/Title ?f'Q 5 \ d Q f\ --r- If' Q 0.. S L.l rQ Y'
Address3Dtf;;t ~{fDrd Cf. . GroJJd ",Juilc+ion, CD g l5r::ll-
I \

Business Phone Number (% ) ~bO' Cj!5 g 3 Home Phone Number (q1t) ) 4- 3 Lf - .3/~~
e-mail AddressY.Y\CL(.sh.R_bctrk~r(@0rI?5I}at)./1 € r

3. Type of organization (Ditch Co., Irrigation District, Municipality, etc.): I 'f'( /'3 a+i.or) (Q,+Qra/
Date of Annual Meeting m Cll'ch
Is the organization incorporated in the State of Colorado? YES X NO_ (If YES, please
include a copy of the articles of incorporation, and the bylaws with this application form.)