BOARD01941

• Board Meeting Date: 11/25/2002
• Description: Technical Assistance to Covered Entities
• Board Meetings - Doc Type: Memo

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Non-reimberusable State Investment Proposal
Colorado Water Conservation Board - CONSTRUCTION FUND

Instructions: This application form should be typed, or printed neatly with black ink. You may attach
additional sheets as necessary to fully answer any question, or to provide additional information that you feel
would be helpful in evaluating this application. If you have difficulty with any part ofthe application, please
contact the Water Supply Planning and Finance Section (Colorado Water Conservation Board) for assistance,
at [phone].

Generally, the applicant is also the prospective owner and sponsor of the proposed project. If this is not the
case, please contact the CWCB staff before completing this application.

Part A. - Description of the Applicant (Project Sponsor or Owner);

1.

Name ofapplicant(s): Colorado Water Conservation BoardIBouvette Consulting
Mailing address: CWCB Office and 1801 Dahlia Street, Denver, CO 80220
Taxpayer ID# email address brad.Lundahl(G)sate.co.us and
[e-mail]
Telephone numbers:

Business
Home
Fax

[phone] and 303-355-4057
LJ
NA and 303355-5318

2.

Person to contact regarding this application, if different from above:

Type of organization: State agency and sole-proprietor.

Is the organization incorporated in the State of Colorado? YES _ NO _X_
(If "YES", please include a copy of the articles of incorporation, and the Bylaws with this application
form. )

5.

Please provide a brief description of the owner's existing water supply facilities.
(Attach separate sheets and a map, if needed.): NA

6.

For existing facilities indicate: NA
(a) The number ofshareholders_, or
(c) Current Assessment per share $_

(b) the number of customers served
(d) Number of shares

Part B. - Description ofthe Project

1.

Name of the project or study: Technical Assistance to Covered Entities

2.

What is the purpose of this grant application? Check one.
_ Demonstration project
_ Study
_ Rehabilitation or replacement of existing facility
.x. Other (describe) - Technical Assistance

General location of the project or study. (Please include county, and approximate distance and

direction from nearest town, as well as legal description): The project will be calTied out statewide.
Colorado Water Conservation Board
Flood Protection . Water Project Planning and Financing. Stream and Lake Protection
Water Supply Protection. Conservation Planning