Laserfiche WebLink
f r . <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> C <br /> Applicant Complete All Sections Below This Line ° <br /> b <br /> Original License Fee= 300 Renewal License Fee (Annually)= $150 N <br /> S2.- Spoain <br /> PropertyOwner's Name: 1 <br /> n ovi <br /> Property Owner's Mailing Address: U-53 Z l l' Si- �,tAc h� WS 9t:Sta <br /> p rtY ZC91 black Bear �CQIi� Dal\ 1Nte 514-83O o <br /> Pro e Site Address: �� rr Q <br /> Applicant's Telephone Number: ((GSA) 2.44q - 1335 <br /> Applicant's Email: Spain 06@)3 Mal I , COM <br /> I 1 1 tl,�G r ' <br /> Legal Description of Property: in�`� Gt AI l \ o GLA" Z�Q54 tlad2 �C�V' d ( <br /> Ti(Ai .� <br /> Section#: 3 n#_ �— N Rage : -W--Town of C-�3' i S 5 7.. <br /> =S �r ►r- i, trach ,nio w.- LUT 54($ <br /> *Attach additions page i) ded for length des ipti attar a copy of the deed OR attach t cy�stem pro erty page.* a (f l <br /> •HCl <br /> Tax ID#(1-5 digit number;found on tax statement): '414r 2,15? Z. 4 <br /> o ?C <br /> Provide Rental Information <br /> al. 1, <br /> License Year Applied For: Q-02-2- Amount of Renters Applied For: - • " W <br /> 41,54rA,ttC �. I b <br /> Local Contact's Name: Seip Shcxing.- g. <br /> Local Contact's Address: aa 53 2.114/ St Lit C k w T 54853 <br /> City State Zip <br /> _ a <br /> Local Contact's Telephone Number: (�51 — 2t-t`t -133.5 � <br /> Most Recent Burnett County License Number: STR- State License Number: DW AT-G9 W 17 W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -3 ; <br /> on set };C. manhole. (s) b� 5/I /LZ L cn <br /> £ cn <br /> * OcG u?an c 111n;+ 40 Li pGo0e,, Indy �l,n 61;1 dren , z � N <br /> * ccnse, c.y,�;c€3 k131123 . <br /> Fee Rec:-3 OUB <br /> L5.1 <br /> Date of staff site visit: 2, - \\ - 22 Initials of site visit staff: <br /> LICENSE APPROVED BY � % DATE: 2 , Z Zco <br /> Eft <br /> LAND SERVICES OFFICIAL <br /> CD c <br /> T, <br /> EO <br /> -rr Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application—Rev 1.2/2020 <br />