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COLORADO WATER CONSERVATION BOARD <br />WATER PROJECT LOAN APPLICATION <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 sign and return this application <br />to: <br />THE COLORADO WATER CONSERVATION BOARD <br />Finance Section <br />1580 Logan St., Suite 600 <br />Denver, CO 80203 <br />Attn: Kirk Russell, P.E. or Anna Mauss, P.E. <br />Phone (303) 866 -3441 x3232 Fax (303) 894 -2578 <br />Email kirkxussell(c�,state.co.us or anna.mauss(&state.co.us <br />Part A. - Description of the Applicant (Generally, the applicant is also the prospective owner and <br />sponsor of the proposed project) <br />1. Name of applicant Town of La Veta, Colorado <br />Mailing Address P.O. Box 174, <br />La Veta, Colorado 81055 -0174 <br />Business Phone (719)742-3631 <br />Federal ID Number 86- 6000686 <br />2. Person to contact regarding this application: <br />Fax ( 719 ) 742 -5420 <br />email: townoflaveta6Dcenturytel.net <br />Name Don Keairns <br />Position/Title Mayor <br />Address P.O Box 174 La Veta CO 81055 -0174 <br />Business Phone ( 719 ) 742 -3631 Cell ( ) <br />Email townoflaveta(i�centurytelxet <br />3. Type of organization (Ditch Co., Irrigation District, Municipality, etc.): Municipality <br />Date of dal- Meeting Twice a month <br />Is the organization incorporated in the State of Colorado? YES X NO (If YES, please <br />include a copy of the articles of incorporation, and the bylaws) <br />1 <br />