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COLORADO WATER CONSERVATION BOARD <br />WATER PROJECT LOAN APPLICATION <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 sign and return this application <br />to: <br />THE COLORADO WATER CONSERVATION BOARD <br />Finance Section <br />1580 Logan St., Suite 600 <br />Denver, CO 80203 <br />Attn: Anna Mauss, P.E. <br />Phone: (303) 866-34410774 Fax (303) 894 -2578 <br />Email: annamauss(a-Ntate.co.us <br />Part A. - Description of the Applicant (Generally, the applicant is also the prospective owner and <br />sponsor of the proposed project) <br />1. Name of applicant Center of Colorado Water Conservancy District <br />Mailing Address P.O. Box 1747, Fairplay, CO 80440 <br />Business Phone 719 816 2330 Fax (719 83x6 2328 <br />Federal ID Number 84- 1449967 email <br />2. Person to contact regarding this application: <br />Name,lames W. Culichia <br />PositionrTide Attorney <br />Address319 North Weber Street, Colorado Springs CO 80903 <br />Business Phone Z 19 471 1212 Cell 7119 333 0054 <br />Email jwc @fmcwater.com <br />3. Type of organization (Ditch Co., Irrigation District, Municipality, etc.): water conservancy District <br />Date of Annual Meeting NIA Board meets monthly <br />Is the organization incorporated in the State of Colorado? YES ❑ NO ❑✓ (If YES, please <br />include a copy of the articles of incorporation, and the bylaws) <br />1 <br />