DEPARTMENT OF PLANNING AND NATURAL RESOURCES
DEPARTMENT OF PLANNING AND NATURAL RESOURCES APPLICATION FOR A MOORING PERMIT INSTRUCTIONS: ALL APPLICATIONS MUST FILL IN ALL NECESSARY INFORMATION IN A LEGIBLE MANNER. Owner’s Name: (Last) (First) Home Address: Telephone No. Current Location of Vessel to be Moored: Business Address: Zip Code: Email address Name, Address and Telephone Number of Resident Agent, if Applicable: Boat Name: Homeport: Registration No.: Documentation No.: Make of Vessel: Builder/Manufacturer No. (H.I.N.): Color: Type of Vessel (Check One): Sail Auxiliary Power Physical Description: Length: Width: Draft: Attach current color photo of vessel and provide one of the following to show proof of ownership: 1. Notarized Bill of Sale 2. Purchase Agreement 3. Affidavit with Facts Therein to Support Claim of Ownership 4. Copy of Current Coast Guard Document 5. Current Registration from Another State MOORING LOCATION REQUESTED 1st Bay and GPS Coordinates: 2ndBay and GPS Coordinates: Bottom Type (i.e. sand, mud, etc.): Bottom Type (i.e. …
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DEPARTMENT OF PLANNING AND NATURAL RESOURCES APPLICATION FOR A MOORING PERMIT INSTRUCTIONS: ALL APPLICATIONS MUST FILL IN ALL NECESSARY INFORMATION IN A LEGIBLE MANNER. Owner’s Name: (Last) (First) Home Address: Telephone No. Current Location of Vessel to be Moored: Business Address: Zip Code: Email address Name, Address and Telephone Number of Resident Agent, if Applicable: Boat Name: Homeport: Registration No.: Documentation No.: Make of Vessel: Builder/Manufacturer No. (H.I.N.): Color: Type of Vessel (Check One): Sail Auxiliary Power Physical Description: Length: Width: Draft: Attach current color photo of vessel and provide one of the following to show proof of ownership: 1. Notarized Bill of Sale 2. Purchase Agreement 3. Affidavit with Facts Therein to Support Claim of Ownership 4. Copy of Current Coast Guard Document 5. Current Registration from Another State MOORING LOCATION REQUESTED 1st Bay and GPS Coordinates: 2ndBay and GPS Coordinates: Bottom Type (i.e. sand, mud, etc.): Bottom Type (i.e. sand, mud, etc.): If yes, check one: Part-time Full-time Will there be any person(s living on board the vessel? Yes No; Inspection: Number of persons: STATUS OF APPLICATION Original: Approved: Disapproved: Relocation: Fee Schedule: Annually $10.00* Recreational $15.00* Live-Onboard $20.00* Commercial *Fee is per foot Payable by certified check, money order or cash, which is non-refundable. NON-TRANSFERABILITY OF MOORING A PERMITTEE SHALL NOT SELL, LEASE, ASSIGN, RENT, TRANSFER OR, IN ANY WAY, PERMIT THE USE OF A MOORING TO ANOTHER PERSON UNLESS AUTHORIZED IN WRITING BY THE COMMISSIONER. (T25 VIC SEC. 405(b), T25 VIRR SEC. 405-9a)). I HEREBY CERTIFY that the foregoing information provided is true and correct; and further, I agree to fully comply with the statutes of the Virgin Islands and the Rules and Regulations of the Department of Planning and Natural Resources related to Mooring and Anchoring in the United States Virgin Islands. Date: Owner or Authorized Representative: Location of Approved Mooring: Approved by: Title: Howard A. Forbes Sr., Director Date Approved: ____________________ M & AVHBA – 09/2001 Mooring Permit 1