2. Water Structure Permit Application
4. Name/Organization*
6. Existing Permit # (if applicable)
7. Name of Lake*
8. Type of Structure*
   -- Select One --Boat LiftLoon Nesting PlatformMooring BuoySwim PlatformSwim Area Buoy
10. Address of Structure Location/GIS Parcel Number*
11. City/Township*
13. Is the water structure going to be placed in front of the applicant's/organization's riparian zone? *

    1. Yes
    2. No
15. If no, enter the name/organization of who controls the riparian zone where the water structure will be placed in front of.
17. Does the above-mentioned entity consent to having a water structure placed in front of their riparian zone?*

    1. Yes
    2. No
    3. N/A
19. Is there any other information regarding this structure we should be aware of?
21. Contact Person
23. Last Name*
24. First Name*
25. Middle Name*
26. DOB: M/D/YY*
28. Street Address*
30. City*
31. State*
32. Zip Code*
34. Phone Number*
35. Type*
    -- Select One --CellHomeWorkOther
36. Email Address
38. Please print a copy of this form and submit it along with a fee for $20 to:

    Crow Wing County Sheriff's Office

    Attn: Boat and Water Permitting

    304 Laurel Street, Brainerd, MN 56401

40. Water Structure Permits are valid for 5 years.
42. 
    
44. 
    
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45. Print Only

* indicates a required field