Marine Safety Program
Application for Permit to Operate a Boat Livery
This information is required by authority of Part 445, 1994 PA 451, as amended.
Applicant / No. of Non-Motorized Vessels
Business Name / Page
of / Canoe(s)
Name of Applicant / Date of Application / Kayak(s)
Street Address / County / Rowboat(s)
City, State and ZIP / Name of Body of Water / Sailboat(s)
Motorized Vessels
The following vessel equipment is necessary to pass inspection:
1. USCG Approved Personal Flotation Device (PFD) 2. Oars or Paddles 3. Anchors and Line 4. Hull in Good Condition 5. Level Flotation
Capacity
Plate Number / Michigan MC
Registration Number / Hull Identification Number / Capacity Information / Tab
Affixed / Type of Vessel / Vessel Pass/Fail
H.P. / Persons / Weight / Motor Boat / Pontoon / Jet Ski / Pass / Fail
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
Total Vessels This Page
Total Fees Collected / $
Inspectors Report / First Inspection Re-Check / A navigable waters livery boat is a motorized livery boat greater than 20’ in length that is used on navigable waters. A navigable waters livery boat shall be subject to a comprehensive dockside inspection performed by a State of Michigan, Department of Natural Resources Conservation Officer. Please contact your local Sherriff’s Department or DNR office for Navigable Waters Livery Boat Inspection Application.
Date of Inspection
Name of Agency / INSPECTING SHERIFF’S DEPARTMENT:
Please mail copy of this completed application to:
MARINE SAFETY PROGRAM
GRANTS MANAGEMENT
DEPARTMENT OF NATURAL RESOURCES
PO BOX 30425
LANSING, MI 48909-7925
Inspector’s Name (print)
Inspector's Signature / Date
Distribution:
• Original - Sheriff's Office • Copy: Department of Natural Resources-Grants Management. • Applicant: Retain Copy PR1930 (Rev. 09/24/2012)