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C C <br /> r. <br /> <. 9 tel <br /> N a <br /> SHORT-TERM RENTAL LICENSE APPLICATION— Burnett County, WI <br /> g <br /> Applicant Complete All Sections Below This Linea p <br /> d <br /> Original License Fee= $300 Renewal License Fee (Annually) = $150 ` ,1� <br /> Property Owner's Name: iv d-,7 (_F5 4C/1 t-L(... 6Ie cif. el Ark"CI Ri hev4Son) <br /> '--). <br /> y <br /> Property Owner's Mailing Address: $y3 PrA}rit Meade e.S 0✓ iivel sop, La diel, < <br /> B City State Zip t- <br /> Property Site Address: 3 B y1" covh-/ R.A d (31 Site l! “ke t (...T Syi 91 J <br /> a <br /> Applicant's Telephone Number: (S1- ,2,2 it -RRif y 0 <br /> 1 1 <br /> Applicant's Email: 11 Ara J l e 5•Atv f c wt A;1 . e An o. <br /> o <br /> Legal Description of Property: S'ns ie-.cc,,r...N tp(nC t7 <br /> Ps <br /> Section#: (p Town#: 38A) N Range#: /S W Town of: Let-FO //f fie ov <br /> S. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* S. <br /> O ( o lib <br /> Tax ID#(1-5 digit number;found on tax statement): qg 64 5. ,t - <br /> 0 <br /> Provide Rental Information ' c„ <br /> License Year Applied For: ..0 a/ Amount of Renters Applied For: d p f i <br /> Local Contact's Name: Tr0.�S karpoe-.CZ - <br /> z <br /> Local Contact's Address: 9/LtROSQ /�VQ, i 4P:tC L.et'Gr wSI/ /2 � <br /> n g City State Zip <br /> / <br /> Local Contact's Telephone Number: ! S- Q - 31/7 <br /> �r r, <br /> Most Recent Burnett County License Number: STR- State License Number:Wf(70 i'Cage 7(, 'i <br /> x <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAF} COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: y a <br /> 0fo(toy) a!( J; te✓t`r`t� re tut; rept&tiS <br /> it <br /> 1 <br /> 411 <br /> Fee Rec:r`9 <br /> 1.- s C._ /D <br /> 440 <br /> Date of staff site visit: g 10 1 I" ! / Init'.is of 1'te visit staff: n <br /> / 7/4/21 <br /> - . C,„__:1 <br /> LICENSE APPROVED BY : <br /> V /� A.(A DATE: w W <br /> LAND SERVICES OFFICIAL o a <br /> m <br /> r cs 2 <br /> A ED ' N <br /> n N!m o Oc <br /> h) = <br /> i' 2 <br /> Page 1 of 3 y <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2020 i 1 N <br /> 1 <br />