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CA <br /> r <br /> a `o ... <br /> a 7 n <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI y: ° 0 <br /> s o 3 <br /> fD <br /> to <br /> Applicant Complete All Sections Below This Line ,- r7 <br /> Original License Fee = $300 Renewal License Fee (Annually) = $150 "� r <br /> Property Owner's Name: a `V") k� /l /1� y <br /> q a w 0 x) '.,b <br /> Property Owner's Mailing Address: • 70 < it; <br /> ((�� � ��n/� r,, City StateL Zip - r <br /> Property Site Address: "�/�N J �Y (,j �j-a i- <br /> i Po <br /> Applicant's Telephone Number: 1 (6" , <br /> 3 C -81G14 c„ <br /> Applicant's Email: w 1 C 1tV'i &3g c + ‘conA c <br /> Legal Description of Property: 4—)r Q C 5 M V`f P Ila 4- p1''lot"�Lt 5m V 1 to P35 d II <br /> Section#: 1,4 Town#: ?jS N Range#: c 5 W Town of: k a`c C II a-fite, il 01 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* a - 1 <br /> c2 P n L-.)--. <br /> Tax ID#(1-5 digit number;found on tax statement): 32 53 a. E N <br /> -roar 154- Roo��,crui LI o <br /> Provide Rental Information ICUs ftgl fl 2)WOO <br /> �� w <br /> License Year Applied For: 2-02( Amount of Re ters Applied For: (4 1 R.14 N 5 r <br /> CD 10 <br /> Local Contact's Name: &IWO <br /> Local Contact's Address: - r `��/1 1) 3i . ed 1 () -id ithO T f 1 o 5z1S)7�1 z <br /> o , <br /> _ City State Zip <br /> Local Contact's Telephone Number: -21 S` 3 `1/�! 7 SY, tr- <br /> „' J <br /> Most Recent Burnett County License Number:_STR- 0 State License Number: N�IZ 1 t3 Orlin 4 -. <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -' <br /> 0 mee,\- all 1;catis: re k,rerhe4+s on p3• <br /> z <br /> 1 <br /> a <br /> r- Fee Rec: t/ <br /> z a �,�� <br /> J <br /> Date of staff site visit: 6/ry I ?I Init' o Si I/visit staff: u 0 <br /> Wil <br /> LICENSE APPROVED BY : 1 ; , i/_/z,7i, DATE: gii 6;l ;l ” co C eM\ <br /> LAND SERVICES OFFICIAL // G• �-►-; <br /> c, oo H <br /> c ... <br /> • . <br /> w aCD <br /> Page l of 3 , <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2020 LL- <br /> m <br /> X <br /> 0 <br />