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I:.£�.....:e Cr,versr;e - Tne join:3y v.sei 80:.. s e r� �n,s:r e by on. of the f _lo:ri <br />10 <br />*A- ; :�o1>erty owner's �o:�ecti+ner's olicy. CActi•d,v, <br />_ sepnrate I;ro—pAssocintion owned :o_.icy. <br />list the followin^ info: r.n+;ion: <br />name of <br />insured <br />L +� _ A'v�,�i <br />Name of <br />insurance <br />carrier <br />name of <br />insurance <br />oj;er,cy <br />ICAr3Ak LA, + - jziL4,fr•I4. <br />policy <br />no. Ii "-!I, <br />effective date of coverage <br />S7 <br />amc.unt <br />of coverage; i'ublic <br />liaLil`_:;;, p;r person, per occurence $ <br />2� <br />Fubi:c <br />1'_ability, per occurence $ <br />2 � <br />Security arid policing of the Ioirtl;,• used dock and property is provided b5 <br />(check ePpliceble items): <br />_ fencing. security lighting. A property owner's presence. <br />_ contract securit.,, service. of'ner (specify) <br />DOCK IPFF RWiTIOW <br />11. List Dock Use Area Specifications: ti 51fE fJ, , let <br />Nidt.n of shoreline; ft. LenRti. of ma_r% dock from shore; ft. <br />Dock setLacks from side property lines at shore; ft. and ft. <br />12. Dock Construction (check applicable items): <br />seasonal dock (relocated or realace3 eac year). <br />_ r.ermenent piling with seasonal deck. 2 permanent piling and decr.in(-. <br />wooden decking. metal decking. <br />13. List Dock Acces£ories: <br />Number of fire extinguishers svri?e:':e et the doc oki, B'At <br />Nwr:ber of life preservers availst)le r t the .'Dck <br />14. List number of slips in eecl: et teCory ("sI ir.s" inciudee boat lifts): <br />Transient (day use onjy) slips Transient(dey use) off -shore buoys <br />Iermanent moorage slims S }ermnnent moorc.Fe off -shore buoys <br />Dry storage (rack) slits Maxiir.um number of beats at the deck 5 <br />1�. List nur,'uer of off-street }parking spaces available for userr of the ,Joint use <br />docK. inrkint,, If ymvided must not be sepmrnted fmm the dock by sny public <br />pond. -Adi_ s.,,ces . <br />3 u f' S <br />