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tml <br /> Z r <br /> ri ... <br /> V CD n <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI CA <br /> ° <br /> C <br /> Applicant Complete All Sections Below This Line - <br /> d. g <br /> Original License Fee=$300 Renewal License Fee(Annually) =$150 - et <br /> I' ('/ <br /> Property Owner's Name: n "l' DC(V1 I e/' - w y <br /> CO'01 t pti <br /> Property Owner's Mailing Address: 132- 1 )p N Vv hewk (YIN Ss3CLI o <br /> p � ry- City j 1 State Zip r ' <br /> �15 <br /> Property Site Address: c2 4 DU 35 I'`(� Vit l bU r 1� W I S'[?3 (-T 2- r eApplicant's Telephone Number:(Q12 - t961_ "1a?- <br /> X <br /> Applicant's Email: m t n J 4 S 4 V l t e j 9 ma l ( . LI;YV?< g <br /> G r J 6.r <br /> Legal Description of Property: 1- 5 CS M 1630 VO I g P 3 k'�1C C ctS 2i2(> g o o c. <br /> d <br /> Section#: 1 w Town#: HD N N Range#: W W Town of: Oa K t u'i&1 N w 7 <br /> Q.-- <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* occ p <br /> d no <br /> Tax ID#(1-5 digit number; found on tax statement): I Lcg 1 I a.< W '" <br /> o <br /> Provide Rental Information �,p r w <br /> I <br /> License Year Applied For: 20 22 Amount of Renters Applied For: -}-H --(2) $ r.1... N <br /> . <br /> D <br /> -C.:0 <br /> I ( <br /> Local Contact's Name: rOc FC s da g O <br /> (1c co <br /> _ - — z <br /> Local Contact's Address: , : 1 Pr I ' -N: !''' 7 _ <br /> 2 2 C n '1 ZL� City State Zip 0 D <br /> Local Contact's Telephone Number: --��--r�-9. 7 1 5 - 3 3$ - 6oO2. K t, <br /> cn v <br /> Most Recent Burnett County License Number:_STR- State License Number: 1)WW kT't I J�r 3 ,`i <br /> N x <br /> J o <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> oil 35 ��, Danb�r , W t `s <br /> Loco.\ eor„�a�� adc e5s: 2q 02,5 r k p 0 00 <br /> Ma k room a ra000''S ri � <br /> o- encc'S ‘s S eople.it Ntncl1/4) '1 cinMeen z <br /> Fo\\aw 0..\\ \,c.t- 'se, c ;icedmens. <br /> x <br /> x <br /> 7 <br /> cn <br /> oFee Rec: <br /> c Ck#: c2-C) <br /> m <br /> 70 <br /> Date of staff site visit: \ - 15 2..Z. Initials of site visit staff: K 1- <br /> 0 <br /> LICENSE APPROVED BY : 7i/fiu&ftL d.6*(4) DATE: 1 - 3\ - 2-2 co <br /> r <br /> a <br /> LAND SERVICES OFFICIAL ,'u co rn 0 <br /> .0 A <br /> ;moo 0 <br /> CD c -"''7 <br /> Page 1 of 3 <br /> g 1511 <br /> Burnett County,WI Short-Term Rental License Application-Rev 12/2021 <br /> L -.) <br />