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c r <br /> c o ... <br /> y CD A <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI y: ° = <br /> Applicant Complete All Sections Below This Line o a <br /> w <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 A <br /> Property Owner's Name: Jason Dorgan C9 1 y <br /> Property Owner's Mailing Address: 5619 Gamble Road,Duluth MN 55804 , t) <br /> 4570 Lunsman Drive City State Zip r Lt) <br /> '1 <br /> Property Site Address: Town of Swiss WI 54830 ° r <br /> R <br /> 218.409.4461 R <br /> Applicant's Telephone Number: x p <br /> Ts <br /> C <br /> Applicant's Email: <br /> dorganjason@yahoo.com . <br /> g g U <br /> Legal Description of Property: Lot 2 CSM#1488 V 7 P 248(in Gov Lots 2&3)#220059 N o <br /> Section#: 26 Town#: 41N N Range#: 15W W Town of: Swiss `" o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* w `'' <br /> t7 ug b' 0 <br /> Tax ID#(1-5 digit number;found on tax statement): 21620 a, < $ot",, 0 <br /> o .$ <br /> •t� Provide Rental Information v - <br /> License Year Applied For: 213' t Amount of Renters Applied For: 8 <br /> N <br /> Local Contact's Name: 5.t AA.% 1 )"- ro - <br /> Local Contact's Address: 4/6 t/ Z-44-6 A I'Cof, aA4.iigy' PL <br /> 1 . 31/B30 L <br /> r` 66— ��q City State Zip <br /> J <br /> Local Contact's Telephone Number: 7 J � , <br /> cn N <br /> Most Recent Burnett County License Number: STR- State License Number:DW4-T C3QP5 tv O '' <br /> `s <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: F ' <br /> IS 1:%cense ey.e,ce. s - 31 - 23. _ CA N <br /> bct Q ?anc�l �,m;� ;s ld ? e-o?le.I ►ncluc\;els (AO c1 ren . z t" Q <br /> LIN <br /> vt <br /> 2 <br /> o Fee Rec:3(DcCC) <br /> i Ct Air - 7(i <br /> m <br /> Date of staff site visit: 3 — 2.1 - Z 2- Initials of site visit staff: 1,1— m <br /> F) <br /> tl <br /> LICENSE APPROVED BY . <//1/1411-11/ <br /> �4.Z /(" DATE: 3 - Z 2 - 2 2 a <br /> LAND SERVICES OFFICIAL z a <br /> m 2 = ...r <br /> mHCS .-. <br /> ri i 2 <br /> = o <br /> Page 1 of 3 ° c4 <br /> Burnett County,WI Short-Term Rental License Application-Rev 1/2020 x a` `%' N� <br /> m Lc <br /> rn <br /> m <br />