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�1. Atsoc�atlon iE (chcc <br />1� <br />XnJncontcrctcd 'normov"ner's c;mi.t. <br />lncorporuted Hor,:ecwncr's Associatiorn. <br />_ unincorporeted club or recreation group. <br />_ incorporated club or recreation group. <br />5 • Frinncil•a?. purpose of joint use dock is (check erplicabie items ): <br />�/ provide boat moorin4; and lake access for residential property. <br />_ provide sr:i:aening uccesc. beach, or offshore dock. <br />— provide a club or eseociation 6ethering piece for activities. <br />6. Dock is located on (check applicable item): <br />_ cr,e me:Tter'S private nroperty. <br />Zeasenient or outlot owned in common. <br />_ property leased by the groupAssocietion. <br />_ property owned by the group/essocietion. <br />7. List Dock location and o%nershic inforration: <br />street eddress <br />legel property descriritior. <br />PID # <br />listed property owners <br />B. Names of abutting lakeshore property owners: <br />(North/West) <br />(Name + Address) <br />South/East <br />Name + Address) <br />Names of other affected property owners: <br />(Name + Address) (attach sheet if necessary) <br />Ci,V� c c <br />{, C, (1 " (J J C�r� LA ,� <br />2 of' 5 <br />