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7-18-07: 2:40PM: ;93038942578 <br />COLURADO WATER CONSERVATION BOARD <br />CONSTRUCTION FUND LOAN APPLICATION <br />Instructions: This applica.tion should be ryped or printed neatly wi~h 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 />THE COLORADO WATER CONSERVATION BOARD <br />Water SuppIy Planning and Finance Section <br />1580 Logan St., Suite 750 <br />Denver, CO 84203 <br />Attn: Kirk Russell, P.E. or Bruce Johnson, P.E. <br />Phone Number 303/866-3449 - Fax Number 303/894-2578 <br />e-mail: kirk.n~cs .)lnstate_ n ns Or hn~ce_.inhncnn(~ctat ..n.us <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 />compieting this application.) <br />1. Name of applicant Tnwn nf Hillrnce <br />Mailing Address p(~ RnX t ;11ros , c'(~ R07'~'~ <br />Business Phone Number (970~ R47_~7(1 <br />Federal ID Number g4_h~953 t t <br />Fax Phone Number (9~.71# R47-37F 1 <br />e-mail address t~L~mhillrneP~a~n~rmatinn cnm <br />2. Person to contact regarding this applicarion: <br />N3me L~+nn C;nlPmh~cki <br />POSitiOt]/Title Tnum ( 1Prk,~ Adminictratnr <br />Addt'eSS P f~ Rnx ~ rH1~~TQ;CP.~ (":C? Rtl7?~ ___ <br />Business Phone Number (970)R47-37Ft Home Phone Number (970;.547-322n- <br />e-mail Ad(1Tess tnvy illrncenp,aoinfnrmatinn_cnm <br />3. Type of organization {Ditch Co., Irrigation District, Municipality, etc.):M~mir' ali <br />Date of Annual Meetin~ _~ ~. ~ M~n~vs nf ea~h u„n„th <br /># 2/ ii <br />Is the organization incorporated in the State of Colorado? YfiS X NO (IP YES, please <br />incIude a copy of the articles of incorporation, and the bylaws with this application form.) <br />