2008 HOUSEBOAT MOORAGE LICENSE AGREEMENT
_______________ 51 feet and above $2,750.00 ____________
Under 50 Foot $2,600.00
________ $275.00 Monthly payment by 1st of each
month beginning January 1, 2008.
(Includes $100.00 Annual Inspection Fee which is required
by YCWA Ordinance.)
Fees are due no later than December 31, 2007.
LICENSEE / REGISTERED OWNER(S) Name and address information for all additional registered owners must be provided
on back.
I. Name___________________________________________________________________________
Home Address____________________________________________________________________
Mailing Address___________________________________________________________________
City ____________________________________ State___________
Zip Code _________________
Home Telephone_________________________ Drivers License
No._________________________
Cellular Telephone __________________ Work Telephone________________________________
Email Address ____________________________________________________________________
Emergency Contact_______________________________________Telephone____________________________
II. DESCRIPTION OF VESSEL
Vessel Name ____________________________________CF #_______________________________
Boat Manufacturer _______________________________Year
Built__________________________
Hull Type____________________________________Color_________________________________
Length /Width _____________Engine Manufacturer ____________________Horsepower________
Engine Type: ____O/B ____Inboard ____I/O Fuel Capacity_____________________
Water Capacity: _______# Gals. Sewage Gallon Capacity: _____ Black _____Gray
III. INSURANCE
CARRIER
Company______________________________________________Agent______________________
Policy#________________________________________________PolicyTerm__________________
Type of Coverage_______________________________________
Policy Limits ________________
Owner must provide proof of required liability and property insurance for Vessel as required by Marina, naming Marina as additional insured.
By signing below, you are acknowledging you have received and read the Terms and Conditions and Rules
and Regulations enclosed.
_______________________________________________________________________
LICENSEE / AGENT
DATE
________________________________________________________________________
MARINA REPRESENTATIVE
DATE
Licensee must sign and date the license agreement and return this page to Marina with payment by December 31, 2007.
Please include name/address information for all additional legal owners on the back of this form.
