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<br />~ . <br /> <br />. <br /> <br />. <br /> <br />_ CWCB Emergency Repair Account Loan Application <br />Revised JuneS, 1993 <br /> <br />3, Is the oIganization incorporated in the State of Colorado? YES_~_ NO <br /> <br />(If yes, please include a copy of the articles of incorpoIation, and the Bylaws with this <br />application form.) <br /> <br />4. Person to contact Iegarding this application, if different from above: <br />Name: Margaret Swope <br /> <br />Positionltitle: Office Secretary <br />Mailing address: P.O. Box 286, 401 Broadway <br /> <br />Penrose, CO 81240 <br /> <br />Telephone number: Business <br />Home <br /> <br />(719) 372-3664 <br /> <br />( <br /> <br />) See Attachment B <br /> <br />5. Please provide a brief description of the owner's existing water supply facilities and <br /> <br /> <br />describe any existing operational or maintenance problems. (Attach separate sheets, and <br /> <br />a map, if needed.): See map - Attachment A <br /> <br />6. For your water supply facility, please indicate: <br />and <br /> <br />(a) the number of shareholders 410, IDl (b) the number of customers served 1338. <br /> <br />These numbers represent 410 irrigation shareholders and 1,338 domestic <br /> <br />users. <br /> <br />Part B. - Description of the Emergency <br /> <br /> <br />I. What type of facility requires the emergency repair? <br /> <br />-2 Raw Water Storage System; Dam or Reservoir <br /> <br />_ Raw Water TIansmission System; Canal, Ditch, Pipeline <br /> <br /> <br />Diversion dam or Headworks <br /> <br />Other <br /> <br />Please describe the facility: <br /> <br />2 <br />