"Application for Dry Storage Use Permit" - Hawaii

This "Application for Dry Storage Use Permit" is a document issued by the Hawaii Department of Land & Natural Resources specifically for Hawaii residents with its latest version released on June 1, 2011.

Download the up-to-date fillable PDF by clicking the link below or find it on the forms website of the Hawaii Department of Land & Natural Resources.

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Download "Application for Dry Storage Use Permit" - Hawaii

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APPLICATION FOR
DRY STORAGE USE PERMIT
Division of Boating and Ocean Recreation
Department of Land and Natural Resources, State of Hawai'i
1. PERMIT INFORMATION
Island (
) :
q
Hawaii
q
Kauai
q
Lanai
q
Maui
q
Molokai
q
Oahu
one
4
OFFICE USE ONLY
Date Received:
Location:
Received By:
Usage Type (
):
q
Storage of Vessel
q
Storage of Trailer
q
Storage of Equipment
one
4
q Temporary storage - repair with mooring:
Start Date:
End Date:
/
/
/
/
Repair Description:
q
Temporary storage - repair no mooring:
Start Date:
End Date:
/
/
/
/
Repair Description:
2. APPLICANT INFORMATION
Name (Last):
(First):
(M.I.):
Suffix:
q
q
Date of Birth:
/
/
Gender:
Female
Male
Occupation:
Employer:
Phone (business):
(mobile):
Email:
3. APPLICANT ADDRESS
Address (
)
Mailing
q
Mail to -OR-
q
In care of
Name:
4 one
Address Line 1:
Apt #:
Address Line 2:
Country:
City:
State:
Zip Code:
Billing
Address (
)
q Mail to -OR-
q In care of
Name:
if different than Mailing Address
Address Line 1:
Apt #:
Address Line 2:
Country:
City:
State:
Zip Code:
4. VESSEL OWNER
q
check if same as Applicant
Owner
's Name (Last):
(First):
(M.I.):
Suffix:
Address Line 1:
Apt #:
Address Line 2:
City:
State:
Zip Code:
Country:
Phone:
Dry Storage Use Permit, Revised: 06/2011
Page 1 of
2
APPLICATION FOR
DRY STORAGE USE PERMIT
Division of Boating and Ocean Recreation
Department of Land and Natural Resources, State of Hawai'i
1. PERMIT INFORMATION
Island (
) :
q
Hawaii
q
Kauai
q
Lanai
q
Maui
q
Molokai
q
Oahu
one
4
OFFICE USE ONLY
Date Received:
Location:
Received By:
Usage Type (
):
q
Storage of Vessel
q
Storage of Trailer
q
Storage of Equipment
one
4
q Temporary storage - repair with mooring:
Start Date:
End Date:
/
/
/
/
Repair Description:
q
Temporary storage - repair no mooring:
Start Date:
End Date:
/
/
/
/
Repair Description:
2. APPLICANT INFORMATION
Name (Last):
(First):
(M.I.):
Suffix:
q
q
Date of Birth:
/
/
Gender:
Female
Male
Occupation:
Employer:
Phone (business):
(mobile):
Email:
3. APPLICANT ADDRESS
Address (
)
Mailing
q
Mail to -OR-
q
In care of
Name:
4 one
Address Line 1:
Apt #:
Address Line 2:
Country:
City:
State:
Zip Code:
Billing
Address (
)
q Mail to -OR-
q In care of
Name:
if different than Mailing Address
Address Line 1:
Apt #:
Address Line 2:
Country:
City:
State:
Zip Code:
4. VESSEL OWNER
q
check if same as Applicant
Owner
's Name (Last):
(First):
(M.I.):
Suffix:
Address Line 1:
Apt #:
Address Line 2:
City:
State:
Zip Code:
Country:
Phone:
Dry Storage Use Permit, Revised: 06/2011
Page 1 of
2
Division of Boating and Ocean Recreation
Department of Land and Natural Resources
State of Hawaii
APPLICATION FOR DRY STORAGE USE PERMIT (
)
Continued
5. VESSEL INFORMATION
Vessel Name:
Port of Registry:
q
Registration
q
Coast Guard Documentation
q
None
Documentation Type:
Reg. or Doc.#:
Expiration Date:
/
/
Mooring Account #:
Hull Manufacturer:
Year Built:
Length Overall:
(feet)
(inches)
Hull ID#:
Number of Hulls:
Length Over Deck:
(feet)
(inches)
Hull Color:
Cabin Color:
Draft of Vessel:
(feet)
(inches)
Top Deck Color:
Trim Color:
Beam of Vessel:
(feet)
(inches)
Trailer Length:
Trailer Registration #:
(feet)
(inches)
Description of Equipment:
6. VESSEL TYPE AND PROPULSION
q
q
q
q
q
Vessel Type ( one):
Open Motorboat
Motor Vessel (more than 65)
Sailing Vessel
Houseboat
Runabout
4
q
q
q
q
Auxilary Powered Sailing Vessel
Cabin Motorboat
Thrillcraft
Dinghy or Skiff
q
Barge
q
Platform
q
Other:
q
q
q
q
q
Principle Use ( one):
Pleasure
Charter Fishing
Commercial Fishing
Commercial Passenger
Charter Bare Boat
4
q
q
q
q
q
Dealer
Manufacturer
Charter Sail
Water Taxi
Other Commercial:
q
q
q
q
Primary Propulsion Type ( one):
Power
Sail
None
Other:
4
q
q
q
q
q
q
If Power: Engine Type(s) ( one):
Outboard
Inboard
Outboard / Inboard
Manual
None
Other:
4
Engine Manufacturer:
Horsepower:
Number of Engines:
q
q
q
q
q
q
If Sail:
Rigging Type:
Sloop
Schooner
Three-Masted Schooner
Four-Masted Schooner
Ketch
Brig
q
q
q
q
q
q
q
q
Brigantine
Barque
Barquentine
Fully Rigged Ship
Snow
Yawl
Cutter
Clipper
Auxiliary Propulsion for Sail:
q
q
q
q
Engine Type(s) ( one):
Outboard
Inboard
Outboard / Inboard
None
4
Engine Manufacturer:
Horsepower:
Number of Engines:
q
q
q
q
Fuel Type ( one):
Gasoline
Diesel
Electric
Other (specify):
4
7. AGREEMENT & SIGNATURE
I agree to comply with the provisions of the Hawaii
Administrative Rules as promulgated by the Division of
/
/
Boating and Ocean Recreation applicable to this permit.
Signature of Applicant
Date
Dry Storage Use Permit, Revised: 06/2011
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