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.. �1 �r:..�-'..... :L' ..Vtt:, f�, - m..n 1..f.:1•- :+f... t '�}-... �C �li'ili?��J� :.•I C'.'iC i._ L..l' _1�1:-. <br />7 �.:v}:ertc.w:,A�•'r .:c,::•rcJ,�c�•'c .•a:.;.c� <br />sel:'rarste owned <br />' ist the folicw , nc; in''ormi.,,ion: <br />name of insured <br />:lame of rtsui-ance carrier <br />name c'.' insurance o ency <br />policy no. effective det.e of coverage <br />e'n:,unt of eovern6e; ; ublie liatilj , r'�r pers;;n, ier occurence $ <br />F'ubl.'e 1'.-ibility, ter occurence v <br />10 • Securi ..y and uolicing of the Jointly used dock and property is ; rovided by <br />(crleck P::1;1 is-ble items) : <br />fencing. security Lighting. r property ovaer's presence. <br />_ contract s-curit; service. other (specify) <br />11. List Dock Ure Area Sj eci f'i ca- i,_,ns : <br />Nidtn of cn^_el_ne; `-J ft. iengti-: of rain dock from whore; ft. <br />Dock settacl s fr-m side ,property lines at shore: <br />12. Dock Construction (check aj:pl.icable items): <br />Q ft. and ft. <br />_ seasonal dock (relocated or re:)Iacei eech/year). <br />m _ peranent pilinD with seesc.nel deck. 1/ perraner:t rilirG find decking. <br />wooden decking. _ metal dec,cin,­,. <br />13. List I ek Accessories: <br />Number of fire extinguishers sw ileble at the dock U <br />Nwiber of lire preservers availaable et the dock O <br />14. List number of slips in eech ceteCory ("slips" includes boat .lift-): <br />Transient (da;,' use only) slips Transient(day use) off -shore buoys <br />Iermenent moorage slips f-ermenent moorf,ge off -shore buoys <br />Dry storage (reek) sl ipr, Maximum number of boats st the dock S <br />IS. List numl..er of off' -street parkire F;.'aceF available for users of the joint u::e <br />dock. 1Nrking, {f provided must not be separnted from the lock by any public <br />road. . 0 spaces. <br />3 of 5 <br />