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r <br /> + v, t r <br /> •d . O ... <br /> N <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI o: y <br /> s <br /> Applicant Complete All Sections Below This Line a. ,-y <br /> R S <br /> CD <br /> Original License Fee= $300 Renewal License Fee(Annually) $150 et <br /> R j , <br /> Property Owner's Name: 'i 1(1 'i LSCC .C1C I)S(/`(\ (� w) <br /> Property Owner's MailingAddress: 4tk) 'Y\` ° 1J <br /> p � IU'15 ��furn� Qc�J� �i1 w� �S`!U�(� � r, N <br /> (� City State Zip ' <br /> Property Site Address: )L=(( i1i.c LdL !U k sitr int-- sii t 53 <br /> // (,� q <br /> (. �F- <br /> Applicant's Telephone Number: �"LM1.j- tett, � l s S q't 0jk'(p rn O <br /> rzr <br /> Applicant's Email: 1 IS C1 ()un II 1( 6;1'1'1(111, c'n •t-e(su re i 6 cj"t(,(!1 2, <br /> LeLegal Description of Property: i S (� ,ti N d n' <br /> g P p rh 1'b o� (stn I p W a �vt poi 1 (sal�t s � <br /> Section#: ))S.' Town#: 3i N Range#: I(, W Town o£ o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* aro <br /> 5.q <br /> n o C— <br /> Tax ID#(1-5 digit number;found on tax statement): II il 98 R. 4 W N' <br /> g C F <br /> 0 <br /> Provide Rental Information <br /> License Year Applied For: 3C))a Amount of Renters Applied For: 8 N 1' 1 <br /> \C,� CD G <br /> Local Contact's Name: f ii1 /11 o <br /> Local Contact's Address: <br /> N 5 00 J C r ictI A 1 in kti *ler ,= a- 1 N <br /> City State Zip Z <br /> ' <br /> Local Contact's Telephone Number: i c - S)-b-- ,otO <br /> lu a 04-131 F I-P 14 c, N <br /> Most Recent Burnett County License Number: STR-21 - 05 State License Number: N ' H <br /> v P <br /> s d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ° <br /> l.;CC(‘Se., eX�,ct,S \ - 3\- 23. .s, i00 <br /> x <br /> * °CC 0 Ra�LM <br /> V, ,Aj ‘S $ ?Go?\L t ,(�G'vC. in C,ht\ (s&n• � CO <br /> G � <br /> )b€ •neS aro tile, yo5'\cc) ?cc- ;AGM \.- 4. L. x 0 <br /> c,.le.wa� No ,cWr A-0 rAc� n <br /> '\ thac cam <br /> `S, cco j �F s*'�?S, - 0 <br /> 0=6 fcoo\ ....1',A.th \3 -Codi overhu ckeo,c-ance)b� 7- 1 - Z2. <br /> 8 Fee Rec: � eg7 <br /> Ck#: <br /> toto <br /> Date of staff site visit: 3 \ — 21 Initials of site visit staff: K L <br /> Fito <br /> LICENSE APPROVED BY : K...1/1Abaki ' i .AA DATE: 3 ' 2- - 2-Z a _ ' ...,..C____ <br /> LAND SERVICES OFFICIAL z a -n U u1' <br /> '� , m 0 <br /> n <br /> 3 DC! <br /> 6 c6 g N C <br /> Page l of 3 c "p <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2021 I <br />