HomeMy WebLinkAbout1989 Charter boat registration v
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f ��`���l�`�'!� : � �` Lake Mi.nnetonka Conservation District
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� 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