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HomeMy WebLinkAbout1989 Charter boat registration v '� - f ��`���l�`�'!� : � �` Lake Mi.nnetonka Conservation District � � � FY--1PR � � �989CD CHARTER BOAT Fee �l [�'S�'� Year ���' % LM.C.D. Emergency Piione Number Name - - - - - - - (f or Lri CD u s e� - - - - - - - - - Because ttiis form is to be copied, please use black ink or type APPLICATION: Cfll�R"1'ER BOA'T REG1S'1'RA'I'ION Pursuant to Lake Minnetonka Conservation District Code Section 3.07, no person shall operate or offer to operate any watercraft carrying �assengers for liire o�i Lake Minuetonka witliout an LPICI) certlficate c�f regLslration. Name of vessel �'/���Y1(� �(�� f r0� AiN license �i MN-� or USCG Documentation �t Name of applicant _ Address & ptione � /� Owner of vessel if different from applicant Address & phone Business name ,(_ /1U������t'� � v ---- — Ad d r e s s & p h o�l e� `�l ly�l1.� , �D/7�lr �`T,�.� Chief pilot � � �'�� — llddress & phone_� �-���- �1���� �--���!�t�-' ,X1 � Other pilots : 1 .� C c� s��s 3. '� � g,ls 2. .! �..5 �-' , 4•._� ' C A. Boat: type .S F _ Capaci_ty: Crew � length _ Passengers � �� � make ' Total year _. - P. USCG-approved PFDs: 1 . Type (Y .l __ �� �..�---� 2. Type / C�! �l 3. TYPe �l _� Total C. Toilet facilities: 7'y��c_-�� -I� � ---- -- - Pump-out point -� . � + , , D. 13erthed at ���__����_ � � L s iore ow►ler' s�e, pliuiie �� � )����� �� y Lakeshore owner's a dres _ � on �' _ , LMCD Area �l � 4/27/84 \ �` . � • Application: LMCD 2 Charter Boat Registration (vessel) . E. Pick-up points ( in order of frequency of use) : . � 1. Usual ` �,� 2. Ol hers ' ' " ' �- �,f- 3. 4. 5. 6. F. Public liability insurance: Amount $ �, , Companysf'�,A/ /'.�o ��4�'f� G. The following must be attached: �1. Copy of current state inspection certificate of operation. �2. Copy of all current pilot licenses. �3. Copy of current charter boat insurance endorsement . �. Locator map showing boat storage and pick-up points. �� L�S. Fee of $50 (please make cliecic payable to LPICI)) . If after tlay 1, also enclose late [ee of $50. Fee $ 5U.00 Late fee Total fee enclosed $�_�( I certify that the information provided herein and ttie attactiments hereto are true and correct statements. Authorized signature Title ' t Date � � � Return application and attachments to: Lake Atinnetonka Conservation District 402 East Lake Street Wayzata, Piinnesota 55391 Phone : (612) 473-7033 . 3 �' Application: LMCD Charter Boat Registration Miss Deduction (vessel) Bradley Hanson Chartered Leasing, Inc. 1930 Sixth Ave. No. Long Lake, MN 55356 C�RTIFICATE of CHART�R 130AT REGIST'RATION No. 89-12 Year 1989 Charter boat registration certificate approved by the Lake Minnetonka Conservation District 5-24-89 is issued sub�ect to the following: (date) continuing validity of submittals - n.amely: state inspection certificate, pilot licenses, insurance, and storage and pick-up points Insurance renewal expiring 7/12/89 and Pilot License expired for Paul Larson, and Bradley Hansen, with (�ike Riley expiring 8/15/89 -- all to be updated• LAKE r1INNETONKA CONSERVATION DISTRIC'T Y — _ _- Eugene R trommen, xecutive Director Date 6-8-89 �=`a.�-�� c: Water Patrol / City where berthed �u-° ` City of port-o-call �a�°�a-��-, �Z�3'��``- 6/89