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DNR COLORADO <br /> CO Colorado Water Water Project Loan Program <br /> Conservation Board <br /> Department of Natural Resources <br /> Application Type <br /> ©'requalification (Attach 3 years of financial statements) )(Loan Approval (Attach Loan Feasibility Study) <br /> Agency/Company Information <br /> Company / Borrower Name: --iTk�es Pu eG ax R--)o.i ic-r <br /> Authorized Agent ItTitle: Ry �E Ste} <br /> Address: 34S— c-Eb,he. 5, X)p1bine4. Cu ga737 <br /> Phone: ( 92 0) cog- 37R 7 Email: sq P.j 1 d 4 Pc kom.coo <br /> Organization Type: )itch Co, istrict[Municipality Incorporated? DES <br /> )ther: 0 <br /> County: Sth4 W c g Number of Shares/Taps: <br /> Water District: b,ST2 c r l - y Avg. Water Diverted/Yr 54i, 9 2/ acre-feet <br /> Number of Shareholders/Customers Served: Current Assessment per Share$. 3.So (Ditch Co) <br /> \ 0 A.-, E L t a S Average monthly water bill $ "A (Municipality) <br /> Contact Information <br /> Project Representative: 440-9 PAAvviE - Tvile16hR6,/ �2./LZAAT,o:. UU'1't'CT <br /> Phone: (g?o ) S/7Lj- g?3 7 1-Email: sei004-. )-A . jci-e I eofrt. G.00 p <br /> Engineer: , ;C)f QA 1-4 - �" <br /> Phone: ( q70 ) 330- (00 ) 9 I Email: d r a k - ® W\Wr - wle[. • Gavv‘ <br /> Attorney: ,g,\ 1:2 <br /> r0 W rj <br /> Phone: ( g70) `107- g000 Email: ty\ rot ,t)® -ci •c , (Owe <br /> Project Information <br /> Project Name: <br /> ARvn0n IrI'li=A S Revnen1— 5TQk(TVA L <br /> Brief Description of Project: (Attacd separate sheets if needed) <br /> ?Q r\ACE —r4 We � an ARM only C',L <br /> General Location: (Attach Map of Area) 3 v, :j S 0 t414 we(iv6 l QED k. G))oa.i o <br /> Estimated Engineering Costs: yCo 0 Estimated Construction Costs: '09)9 Sio <br /> Other Costs (Describe Above): Estimated Total Project Costs: yf`o92 3, 10 <br /> Requested Loan Amount: Project Start Date(s)ft l <br /> (Limit 90%of Total Project Costs) �g�. O0� Design: Aec w aD)to Construction: Se ►a.ei.020)b <br /> Signature <br /> Return to: Finance Section Attn: Anna Mauss <br /> 1313 Sherman St#718 <br /> Denver, CO 80203 <br /> sy72 2% ,16 Ph. 303/866.3449 <br /> (/' e-mail: anna.mauss@state.co.us <br /> S nature / Title Date <br />