BOARD01941

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

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2. Are any of the above liabilities now in default, or been in default at any time in the past? YES - e
NO _ If "YES", please giv;e detailed explanation:

3. Please provide a summary of all revenues received during the last two fiscal years by category (such
as service charges, tap fees, assessments, etc.):

4. Please provide a brief narrative description of potehtial sources of funding (in addition to the CWCB)
which have been explored or which will beexplQred for the proposed project or study. (Examples
would be Local County and Town Govenune~ts, Water Conservancy Districts, USDA Rural
Development, The Natural Resources Conservation Service, The U.S. Environmental Protection
Agency, Commercial Banks, etc.)

The above statements are true, to the best of my knowledg~:

Signature of Applicant:
Print Applicants Name:
Title:
Date:

Please return this application to:
John W. Van Sciver
COLORADO WATER CONSERVATION BOARD
1313 Shennan St., Room 721
Denver, CO 80203

For questions, call [phone]

D:CF GranlApplication 1299

Colorado Water Conservation Board
Flood Protection. Water Project Planning and Financing. Stream and Lake Protection
Water Supply Protection. C;onservation Planning

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