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<br />. <br /> <br />. <br /> <br />. <br /> <br />~ <br /> <br />Non-reimbursable Investment Application - CWCB Construction Fund <br /> <br />Form Revised August 8, 2003 <br /> <br />Lender <br /> <br />Total <br /> <br />Annual Maturity <br />Payment Date <br /> <br />Name/ Acicire~~ <br /> <br />A mount <br /> <br />NLd <br /> <br />2. Are any of the above liabilities now in default, or been in default at any time in the past? <br />YES NO If "YES", please give detailed explanation: <br />NLd <br /> <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.): NLd <br /> <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 /> <br />NLd <br /> <br />The above statements are true, to the ,..best of my knowledge: <br /> <br />'P'~~-/ <br />.< - " / ....-----~_. <br />. ,iF /// I ~- <br />. :' /.1.~~ <br />Signature of Applicant: ~(I/1,. i - <br /> <br />Print Applicants Name: Ray Alvarado <br /> <br />5 <br />