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<br />COLORADO WATER CONSERVATION BOARD <br />CONSTRUCTION FUND LOAN APPLICATION <br /> <br />Instructions: This application should be typed or printed neatly with black ink. Attach additional <br />sheets as necessary to fully answer any question or to provide additional information that would be <br />helpful in the evaluation of this application. When finished, please retum this application to: <br /> <br />THE COLORADO WATER CONSERVATION BOARD <br />Attn: John W, Van Sciver <br />1313 Shennan St., Room 721 <br />Denver, CO 80203 <br />Phone Nwnber 303/866-3441 - Fax Number 303/866-4434 <br />e-mail: john.vansciver@state.co.us <br /> <br />Part A. - Description of the Applicant (Generally, the applicant is also the prospective owner and <br />sponsor of the proposed project. If this is not the case, please contact the CWCB staff before <br />completing this application.) <br />1. Nameofapplicant /JefCa...- {!a.:t1t2.{ (J~~ny <br /> <br /><1d; LAJl6'IlN"/t 4TLWLE.")I <br /> <br />Mailing Address (PD 7 V/6"NT&" <br />])~("'T/i, ('{), "8IWt, <br />"'" <br />Business Phone Number (9'70) $ 79-0$l'.:t5' Fax Phone Nwnber ('1'70 )871-5~77 <br /> <br />Federal ID Nwn~7..:l'l5"' 39/ e-mail Addressi:.mber{.t~7)M&A.net <br />rA)I..No. <br />2. Person to contact regarding this application, if different from above: <br />Name "DAN "PU.T./tIE'Y 6~ 7AwAI'n fJurN'ey <br /> <br />Positionffitle nil-if - PilES. o.c 7/!f"t)ffH (AM eoAlmcr) <br />- <br />Address '1-77 //"(')0 Rd. '])u:rA {'() 8/</11;:, <br />Business Phone Nwnber (enD ) 11 74-7~ 7 Home Phone Number (970) 87'-/ - 9!J8 / <br />e-mail Address &m bert ",@ DfLte: A . /Jet <br /> <br />3. Type of organization (Ditch Co., Irrigation District, Municipality, etc.): canal t!ofhp1-ny <br />Date of Annual Meeting 3/, /:;JOo:2 <br />Is the organization incorporate~ in the State of Colorado? YEs!f-- NO_ (If YES, please <br />include a copy of the articles of incorporation, and the bylaws with this application form.) <br /> <br />'-I <br /> <br />I <br />