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CA r <br /> ... <br /> Cr r9 0. j A <br /> SHORT-TERM RENTAL LICENSE APPLICATION -Burnett County, WI y R, <br /> Z <br /> Applicant Complete All Sections Below This Line = d <br /> Original License Fee = $300 Renewal License Fee (Annually) = $150 2 <br /> �fD <br /> Property Owner's Name: i ell '. 8 ro uin ►-3 <br /> / $J 3C) 5811 LIST PCS �f ciosi(r WI 5 51 g`.3 0 <br /> Property Owner's Mailing Address: / fl f�/ . N <br /> �'y( I Dc ✓' / A Alf e A t COC 1 State11.1 Zip r <br /> Property Site Address: j f Cr 1 _SX &' 3 CD <br /> Applicant's Telephone Number: /' - 2 / ✓ 02 74 % p <br /> Applicant's Email: 4'41'0 G"r 4 gl; AD ' rn Q / d <br /> Legal Description of Property: 4��G C/� S d <br /> Section#:_Z(O Town#: /() N Range#: l,' W Town of: C.- hl Al I N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 050 <br /> Tax ID#(1-5 digit number;found on tax statement): /47/052 4' K N r <br /> n <br /> Provide Rental Information w 1t <br /> License Year Applied For: (� r Amount of Renters Applied For: 4-6 fel <br /> / ro <br /> Local Contact's Name: //// `I L e r t7 W n 00 2 <br /> q 1 J , 4e ,e/ G� r c GUlS�f83 <br /> Local Contact's Address: o�� � �..) Aft$`p+1 <c � <br /> City State Zip <br /> Local Contact's Telephone Number: 6/2- z y5` 2?,‘,/ <br /> 11 JJ QQ ��-�� <br /> Most Recent Burnett County License Number: STR- State License Number:N&� l�ll2GQ51 <br /> d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> ii Lot,. k C-�crt oY " ct't( homed be6re reil.ii� <br /> In .,,Acres ' $ el 50 - ;i- 1, VS;bk.- z Ci <br /> Fee Rec:3'C) <br /> . <br /> ti <br /> rrl <br /> Pzi <br /> Date of staff site visit: 2- 2.1 Initi s o s' • visit staff: 14 L/ <br /> LJ <br /> LICENSE APPROVED BY ,� \../- f/ DATE: I/5/ a CD <br /> LAND SERVICES OFFICIALa r u uU <br /> N .. 0 <br /> a eD N (� <br /> o 0 N U�u�u <br /> Page l of 3 y F g N c <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2020 i 4. N t::- <br /> = 3 rn s3 [NOm <br />