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Non-reimbursable Investment Application- CWCB Construction Fund <br /> Form Revised August 8,2003 <br /> YES NO . If "YES", please give detailed explanation: <br /> 3. Please provide a summary of all revenues received during the last two fiscal years by <br /> category(such as service charges,tap fees,assessments, etc.): <br /> See Steve Shull for Details. <br /> 4. Please provide a brief narrative description of potential sources of funding (in addition to <br /> the CWCB)which have been explored or which will be explored for the proposed project or <br /> study. (Examples would be Local County and Town Governments, Water Conservancy <br /> Districts, USDA Rural Development, The Natural Resources Conservation Service, The <br /> U.S.Environmental Protection Agency, Commercial Banks, etc.) <br /> The above statements are true,to the best of my knowledge: <br /> Signature of Applicant: <br /> Print Applicants Name: Larry Lang,P.E. <br /> Title: Chief, CWCB Flood Protection Program <br /> Date: September 14, 2003 <br /> Please return this application to: <br /> Mike Serlet <br /> COLORADO WATER CONSERVATION BOARD <br /> 1580 Logan St., Suite 750 <br /> Denver, CO 80203 <br /> 5 <br />