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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 -3441 x3224 Fax (303) 894 -2578 <br />Email anna.maussgstate.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 E c K k o -d t F d r m S 1x4 C, <br />Mailing Address 2 / Y ¢S q L✓C Ye 3 3 <br />)'IRSgl(e, CO 606gS- <br />Business Phone ('77o ) 01 Y -- hY 9 Fax ( q 7 ) `oZ 8 y SO 30 <br />Federal ID Number "/ 3 9 3 7 1 email -f!S d e� i@ k,, ,s )tc C O nti <br />2. Person to contact regarding this application: <br />Name Et- a K k C C,K l L a d a-v, , <br />Position/Title <br />Address 6? / y S_LJ WC_ 1C 3a <br />Business Phone Cell (9?z?) 5-3q - O �/ 5 <br />Email - VW S W,. QO WL <br />3. Type of organization (Ditch Co., Irrigation District, Municipality, etc.):-(', g' <br />Date of Annual Meeting 4 <br />Is the organization incorporated in the State o Colorado? YES NO (If YES, please <br />include a copy of the articles of incorporation, and the bylaws) <br />