Long Term Boat Storage Permit Application

Long Term Boat Storage Permit Application

Alaska Department of Parks & Outdoor Recreation
Name*

First NameLast Name
Mailing Address (All boat decals will be mailed to this address)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email*
Name of State Park where you are requesting Long Term Boat Storage*
Other State Park not listed above where you are requesting Long Term Boat Storage*
Description of area to be used for boat storage within the Park*
Example: West bank of Wilson Bear Lake approximately 200ft from the boat launch.
Have you had a long term boat storage permit before?*

YesNo
Previous Permit Number: ASP#######
Requesting To Store The Following:
Vessel Information*
Propulsion:*

MotorizedNon-Motorized
Motor Information*
Please provide vessel or motor details for any category selected as "other" above:
How many years (maximum 5 years) would you like this permit issued for? # of years* (storage cost is $100 per boat per year)
Are your vessels removed seasonally (winters)?*

YesNo
Will all of your equipment be stored in or under the boat?*

YesNo
Long Term Boat Storage Stipulations
I attest the information submitted on this form and any attachments are true, complete, and accurate to the best of my knowledge. The permittee has read and agreed to the terms of this permit and understands that the breach of any of the terms is cause for revocation or suspension. By signing this form, the permittee, its agents, and employees agree to conduct the authorized activities under this permit in accordance with the stipulations herein.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Long Term Boat Storage Permit Application

Requesting To Store The Following: