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Sr^ :T"' ■■'i: <br />r-r..; <br />, '/*• •■] <br />?■ <br />■ ►>.'• <br />'& <br />HTh- lointly used dock is insured ty one of the following: Insurance Coverage - The joim:xy usea. <br />nroperty owner ’s homeowner's policy. <br />separate group/association ovned policy, <br />list the following information: <br />name of insured | ___T'Ar —\/ ^ <br />putBg of insurance carrier <br />of insurance agency <br />.1^ <br />C'*J <br />policy no. (^p/<T/^r^ <br />effective date of coverage //-/- <br />s,„unt of coverage, Public liability, per parsoe, per occurence <br />Public liability, per occurence t <^no ccG <br />rUUXJ.Vi -V / - J V - <br />Security and poUclng of the Jointly used dock and property is provide y <br />(check applicable items): <br />fencing.security lighting. j/property owner's presence. <br />contract security service, other (specify) <br />mCK INFORMATION <br />11. List Dock Use Area Specifications: <br />width of shoreline, 3 ft. Length of main dock from shore, _7^ <br />-o- <br />Dock setbacks from aide property lines at shore, <br />12. Dock Construction (check applicable items). <br />ft. and <br />ft. <br />ft. <br />i <br />U- <br />#■ <br />j^saasonal dock (relocated or replaced each year). <br />_ _permanent piling vlth seasonal deck. _ permanent pliln*. and decking. <br />l/ vooden decking. _metal decking. <br />13. List Dock Accessories: <br />of firm extinguishers available at the dock <br />’'V*' <br />f \_\jSTAT/0^ <br />nUBUJa wx —— - W <br />»nSb.r Of Ilf. preaarvers available at the dock <br />14. Llat n«-bar of allpa In each catego^ rallps" Includes boat lifts): <br />V (day use) Off-Shore buoys <br />Transient (day use on3.y) slips Transxen K 7 <br />14 CO . Permanent moorage off-shore buoys .permanent msorage slips - -_• rennau <br />Dry storage (rack) slips <br />. t'ennancaw --------------- ^ '■« <br />^— . Maximum number of boats at the dock .. <br />15. <br />^ ^ ^ ^ ^