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•C€>- <br />7. <br />8. <br />9. <br />Principal purpose of joint use dock is (check applicable items): <br />^ provide boat mooring and lake access for residential property <br />____ provide swimming access, beach, or offshore dock. <br />____ provide a club or association gathering place for activities. <br />Dock is located on (check applicable item): <br />____ one rrember’s private property. <br />easement or outlet owned in conunon. <br />property leased by the group/association. <br />X. property owned by the group/association. <br />List Dock location and ownership information; <br />Street address 1801 Shcreline Drive > Qrono» MN <br />Legal property description Oitlcfc 1, Fcochill <br />PI D# ______ ________ <br />Listed property owner(s) Fcxhill HoTEcwiers Associaticn <br />Names of abutting lakeshore property owners: <br />tNnrth/Wesri Alden L. & Helen M, Andersen; 1830 Shoreline Drive, Qreno <br />(Name + Address) <br />Michael Winter; 1780 Shoreline Drive, Ckcno <br />(Name + Address) <br />Names of other affected property owners: <br />Ncne <br />(Name + Address) (attach sheet if necessary) <br />Insurance Coverage - The jointly used dock is insured by one of the following: <br />____ property owner’s homeowner’s policy. <br />X separate group/association owned policy. <br />List the following information: <br />Name of insured Foxhill Haneowners Asscx:iaticn <br />Name of insurance carrier Scettsdaie Insurance ;^ency <br />Name of insurance agency Haneyer-Harris Agency___________________ <br />Policy No. GI5 307569________Effective date of coverage 3-01-93 to 3-10-94 <br />Amount of coverage; Public liability, per person, per occurrence $ N/A <br />Public liability, per occurrence $ $1,000^000.00 <br />Page 2 of 5 <br />J