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I- <br />>r-.5. <br />C:. <br />fe' <br />6. <br />S' <br />^y;- <br />'M-'m-m:-7. <br />--V. r * <br />m <br />■m-t <br />8. <br />^7Si <br />•^v <br />Association Is (check applicable iters): <br />xmincorporated bcmeovne-^’ii group. <br />incoiTDOrated Homeovner ’s Association- <br />^^^"unincorporated club or recreation group. <br />Incorporated club or recreation group. <br />Principal purpose of Joint use dock is (check applicable items): <br />pxovlde boat ncoring and lake access for residential property, <br />provide swiinming access, beach, or offshore dock. <br />^X^rovlde a club or association gathering place for activities. <br />Dock la located on (check applicable item): <br />one member's private property, <br />easement or outlet ovned in common, <br />property leased by the group/association. <br />j^^*^roperty ovned by the group/association. <br />List Dock location and ovnership information: <br />street address t 1^0, X* <br />legal property description <br />PID # _________ <br />listed property owner(s) <br />Names of abutting lakeshore property owners: <br />(North/West <br />(Name + Address) <br />Sottth/East) <br />(Name + Address) <br />Names of other affected property owners: <br />s <br />(Name + Address) (attach sheet if necessary) <br />2 of 5 <br />M