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<br />CWCB Construction Fund Loan Application <br /> <br />Lender Name & Address <br /> <br />Amount <br /> <br />Pavment <br /> <br />Date <br /> <br />N/A: <br /> <br />2, Are any of the above liabilities now in defuult, or been in defuult at any time in the past? YES_ <br />NO !!A. If YES, please give detailed explanation. <br /> <br />3. Please provide a sunnnary of all revenues received during the last two fiscal years by category <br />(suchasservicecharges,tapfees,assessments,etc.).OJr Yl'ar-/y /l1(P<; ~r I1Jaier <br /> <br />Are>. i>{(X).oo p,..:s~r. As.s~<:."mt?nts fleE MADE <br /> <br />I/rJ(!{)I'&~ 78 7H..€ tl0.5T ~ 'Tile P~TEa: <br /> <br />ArrllCflEll Repoer ~1lJ ~()Jl.lE ~ La C;T ,;; YR... <br /> <br />4, Please provide a brief narrative description of sources of funding, in addition to the CWCB, which <br />have been explored for this project (Examples would be Banks, Rural Development, NRCS, <br />Colorado Water Resources and Power Development Authority, Colorado Division of Local <br />Government, etc.), NIP. <br />I <br /> <br />5, What coUateral will you be offering for this loan? Possibilities include the project itself, pledge of <br />revenues, real estate, water rights. -the 0/'(') ;f'rf Lf sel-f <br />, I <br /> <br />The above statements are true, to the best of my knowledge: <br />Signature offpplicant <br />By -fJn~.J ~ I I (? u7::-r <br />PrintedName_:P~N"~t.. ::J: 'Pu.:TNe.r-- <br />Title 'Prees;de.-^"f ]:>e& (!1+I'JA~ C:D. <br />Date 3 - .2 S- - :<"0 t:) 2 <br /> <br />C""""""-A400doo <br /> <br />4 <br />