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/rovert.y clvner's <br />sepnrete arc,,,;/rrrocintion ovred ley. <br />.i�;t the fo'ilotiant; infornbl.ion: <br />name of insured <br />:tame of insurance carrier <br />name of insurance ner,cy <br />policy no. effective dote of coveinge <br />emcunt of coverage; Public 3.ia1il'_ . i-ir : ers-.:e, ; er occurence $ <br />F,.Abl'e l:.ability, Ier occurence $ <br />10 • Security and rol icing o: the jointly used 3: ck and. -a_ c: ty is ? r:.vided b, <br />(check applicable items): <br />fencing. _ security lighting. property ovner's presence. <br />.__.. contract securitN service. ot.her (specify) <br />DOCK I*;F FMiTION <br />I. List Lock Use Area Spec ificatiuns: <br />Hi3t.h of shoreline; (O fz. <br />lengt}: of' main doe from shore; :• ft. <br />Dock setbacks from side pmilerty lines at shore; _�_ ft.. and Q _ ft. <br />12• Dock Construction (check applicable <br />seasonal dock ( relocated or replaced es:ch year) . <br />— r.ertranert piling .4.th seescnel deck. 2)(permane:,t piling and decr.ini;. <br />�( woden decking. netel dec�:in,;. <br />13. List Dock Accessories: <br />Number of fire extinEuishern evai)eb;e et t',e doci: W4%.4t- <br />1;ur;ber of life preservers available et the d^ck %__A. <br />14• List number of slips in each cetegory ("slits" inclules beat Lifts): <br />Transient (djay use only) a)jpr <br />Ier-m+c,ent, nr�oleee 61ii.n <br />Dry storuee (reek) slips <br />Transient (doy use) off -shore buoys <br />I ermanent muo;-uee cuff -shore buoys <br />Mnximum number of busts st the dock <br />1 5. List number of off-street Larking rpficer rtva' jnble fur users of the joint. u.:e <br />dock. ParklnC, If prov del mast nut be r.e:r,r•oke,; ''ron� the dcr:; ry eny r'uWaic <br />mad. a,-acer . <br />_. 4 tit' r <br />