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c r <br /> el -. <br /> cr <br /> a o <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI ft <br /> N: <br /> s <br /> Applicant Complete All Sections Below This Line a <br /> a. <br /> Original License Fee= $300 Renewal License Fee(Annually) =C1--5--15 " -.3 <br /> Property Owner's Name: Lv\1f\au, J< re rnp y <br /> .J �-t ,b <br /> Property Owner's Mailing Address: LQ O , Calk V \416 ‘11A)( Cti,�M S 1�-1 OA C�I.L L"� <br /> City State Zip ' <br /> Property Site Address: ac-- ,6 e,a77AC� RGAck Para l 94 X30 '34Th 1 <br /> r �- <br /> Applicant's Telephone Number: '1 t -9.9,(;* -a S 5 41 Cn <br /> Applicant's Email: k 1.0y1 Gt l� I CAA S i-Orn ho1� t S E. a�` C6 i • C-CrYvV <br /> J V . <br /> Legal Description of Property: QafCei. 0c l0.r1Ol. ‘OCa*ea. in 4:30)e,►rn1(1(1e tot ? d <br /> Section#: el Town#: 40 N Range#: 114 W Town of: SCC ., <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* Po • <br /> d n o • <br /> Tax ID#(1-5 digit number;found on tax statement): 0 s1 - k < N <br /> 0 <br /> Provide Rental Information Lk <br /> L '� _ <br /> � <br /> License Year Applied For: I0 a t Amount of Renters Applied For: `C <br /> Local Contact's Name: C�(�� M�Cal� �' _. <br /> -64 <br /> Local Contact's Address: ACICI kQ k alore U az, -I) \I e_ l��bb LJJLel 9-[q30 c <br /> City State Zip <br /> Local Contact's Telephone Number: \‘C-3 - p9 S 6'1 -111 1111 <br /> Most Recent Burnett County License Number: I <br /> _STR- aG -t r State License Number: \ CI" 2-l.\ -' 612_9 L3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY H c <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: g <br /> j, t)pko1c\ �.it I:Ge,t ;rr ; inl S <br /> z <br /> -3 <br /> x <br /> 373 <br /> r Fee Rec:Lc1- <br /> tri <br /> Date of staff site visit: 7/0.7/2-1 Init'.t s I' • to visit staff: IA' poFi <br /> < <br /> /il// / v <br /> rs <br /> cA <br /> LICENSE APPROVED BY : /`., � DATE: 7!A g PI -, - <br /> 1 `b r• <br /> LAND SERVICES OFFICIAL P u• = Hi! <br /> • g; = r <br /> rg ^ N <br /> ggilo gi <br /> Page l of 3 V QI <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2020 g WO <br /> ri- <br /> J <br />