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C r r <br /> _. <br /> a g n <br /> SHORT-TERM RENTAL LICENSE APPLICATION - Burnett County, WI `: o <br /> og IVApplicant Complete All Sections Below This Line a <br /> d e <br /> 16.Original License Fee= $300 Renewal License Fee (Annually)= $150 �)\1 <br /> Property Owner's Name: � '‘''`'"% t-a o� -7,� r 4r .Tc, G _, <br /> Property Owner's MailingAddress: <br /> P rh' `/ Fe rN,..sc�c�c� 5'r• hc::eaV•c' M/V ► /fin },) N <br /> City State Zip 3.3 ' <br /> Property Site Address: 20‘..,7S- S:....r�•SP r• �-,,�„„;� �,�...� col.:, S Y�1`t� � u\ <br /> Applicant's Telephone Number: 6'I Z : te- `12 NCv m <br /> `' o <br /> Applicant's Email: J 6 5 az sire rre--"�' ye of..,cccD l c::+-+ . sl <br /> 66 r 0 <br /> o Legal Description of Property: S Q" .t rr .a,,...c Y;, C7 O <br /> � <br /> g <br /> Section#: 2 CA Town#: 3 2 N Range#: `$ W Town of: 1 CCx.r e..... `.0. G ed 0 <br /> N 2 <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* do N <br /> P c P <br /> Tax ID#(1-5 digit number; found on tax statement): 2- (-j�j 3. E W <br /> o cp <br /> 4- <br /> Provide Rental Information w (° <br /> License Year Applied For: ZC3 1Z, Amount of Renters Applied For: 6� r co <br /> NCD - <br /> Local Contact's Name: M K'y Sa cy Terre e ov -. <br /> z <br /> Local Contact's Address: iCc'C'1 /far-ii, /14 .4 he,., I_ f t ', ..,e Sir.-, wr S`/€ 72_ P <br /> _ City State Zip V-) <br /> Local Contact's Telephone Number: 62 /• •78 3° 33 IP/ <br /> tN <br /> v) <br /> Most Recent Burnett County License Number: STR- State License Number: NV 1?11 -az 64 y lc N — 5 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: i <br /> * 1..% cense, eriP,ce,s 1 '31 -- 23 w <br /> O anc lam (� Peop1G/ ,ncIV �,n ch,ldc'en. <br /> P ` 61.40-61 -6 Aro be. osi'Gt� ak main CO�ran() . z 9— m <br /> G1/4) &e_\,ne.sP ca <br /> x <br /> 0 <br /> r Fee Rec:100, 60 <br /> d Ck#: 1071 <br /> v, <br /> cz <br /> Date of staff site visit: 17 —55 - ZZ Initials of site visit staff: K L <br /> rii <br /> 3 - q - Z2 y <br /> LICENSE APPROVED BY : 71//41/-11C QDATE: w <br /> LAND SERVICES OFFICIAL °z u u <br /> a <br /> N g <br /> m <br /> rz Nn w <br /> c <br /> Page 1 of 3 .0 0) N <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2021 <br /> ,-3 3 N <br /> x I ' <br />