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4. Associntic-r. it (%nec!: aT-!iIicnble itcrs j: <br />I-unlncorl Gratcd norierivner's j;rou.). <br />Xincorporated Homeowner's Association. <br />unincorporated club or recreation group. <br />_ incorporated club or recreation group. <br />5. Frincil•al. purpose Of joint use dock is (check applicable items): <br />X- provide boat mooring and lake access for residential property. <br />provide swimming cceess, beach, or offshore dock. <br />_ provide a club or association gethering plece for activities. <br />6. Dock is located on (check applicable item): <br />one member's private property. <br />easement or outlot owned in common. <br />_ property leesed by the group/essocietion. <br />property owned by the group/essocietioa. <br />7. List Dock location and ownership, inibreation: <br />street eddrrsa SAKI ^5, �'�,��,,vvt YLwPi` <br />lef,sl property description <br />PID # <br />listed property ou er(s) <br />S. Names of abutting lakeshore property owners: <br />North/West. <br />(Name + Address) <br />South/East) <br />(Name + Address) <br />Names of ct:her affected property owners: <br />(Name + Address) (attach sheet if necessary) <br />2 of 5 <br />