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n Covers ill' - Tne jointly ;:.sea do.,k is insuree by ono. of t:je fc`'_:ovIr:�' <br />n:-oy,erty cvner's hori:ecvner's policy. <br />_Zreparate gm,_,.^/^ssocirtion owned _policy. <br />list the following inforination: <br />name of insured <br />Name of insurance carrier <br />name of insurance agency <br />policy no. D1041(6S effective date I f coverage 71Z.S&l <br />amount of coverage; Public liatil'_ty, per person, per occurence S �c�ijz <br />Public liability, l.er occurence $ <br />10• Security and _policing of the jointly used dock and property is provided by <br />(check ePpl.icable items): <br />fencing. 1security lighting. property owner's presence. <br />contract security service. other (specify) <br />DOCK INFrOFMTION <br />11. List Dock Use Area Specifications: <br />Width of shoreline; 2 7�C� ft. Length of main dock from shore; 100 ft. <br />Dock setbacks from side property lines at shore; _7.0` ft. and _ _ ft. <br />12. Dock Construction (check applicable items): <br />_.,e-<easonal dock (relocated or replaced each year). <br />_ permanent piling with seescnel deck. _ permanent piling and decking. <br />.,�oden decking. _ metal decking. <br />13. List Dock Accessories: <br />Number of fire extinguishers eveileb':e at the dock <br />Number of life preservers availoble at the dock <br />14. List number of slips in each ceterory ("slims" includes boat lifts): <br />Transient (day use only) slips Transient(day use) off -shore buoys <br />Permanent moorage slips ' 4 Permanent morage off -shore buoys <br />Dry storage (rack) slips Maximum,, number of boats at the dock __1 4. <br />15. List number of off-street perking spaces available for users of the joint use <br />dock. }erking, 'f provided must not be separated from the dock by any public <br />mod. _lAs.)aces . <br />3 of S <br />