04-11-2005 Council Packet - Laserfiche WebLink

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r 7. 8. 10. List Dock location and ownership information: Street address 500 Tonkawa Rd.. Long Lake, MN 55356 ______________ T^gal property description NS 1/4~~ SW l/4» Sec. 5, Twnsp. 117, Rng 23 PID# N/A ___________________________________________ Listed property owner(s) Dr. Glen D. Nelson ______________________ Marilyn C. Nelson___________________________ Names/addresses of abutting lakeshore property owners: fNorth/West^ Edwin C. Cage/Barbara C. Cage 060 Tonkawa Rd. Mrs. Curtis L. Carlson 550 Tonkawa Rd.___________ Names/addresses of other affected property owners (attach sheet if necessary): NONE 9. Insurance Coverage • The jointly used dock is insured by one of the following: X property owner ’s homeowner ’s policy.__separate group/association owned policy. Name of insured Glen D. Nelson 5 Marilyn C. Nelson ______________ Name of insurance cairia* Chubb Indemnity Ins. Co.__________________ Name of insurance agency Marsh. Inc.____________________________ Policy No. 1245145013 ________Effective date of coverage 7/1/04 - 7/1/05 Amount of coverage: Public liability, per person, per occurrence $____________ Public liability, per occurrence $_____________ Security and policing of the jointly used dock and property is provided by (check applicable iten s): ____fencing _____security lighting X property owner's presence ____contract security service X other (specify) Caretaker________________ Kli*iRMATION 11. List Dock Use Area Specifications: Width of shoreline: 296 _____ft. Length of main dock Dock setbacks fiwm side property lines at shore:______ llOfl shore: ft. and ft. ft. 12. Dock Construction (check applicable items): X seasonal dock (relocated or replaced each year) ____permanent piling with seasonal deck _____permanent piling and decking X wooden decking ____metal decking Page 2 of 4