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e r- <br /> cr ft <br /> P.:: to <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI S: " ° <br /> Z <br /> CD <br /> Applicant Complete All Sections Below This Line d <br /> Original License Fee = $300 Renewal License Fee (Annually) = $150 LZ.,=D <br /> Property Owner's Name: , 7 (''1 1-1-11 ( D E="14-1-2 5 /op ttiv,$G v CES 4 A55�..-�S o 1-3 <br /> Property Owner's Mailing Address: 3° 2 5 � R.� f('4 K� 4`4e-Ak / G0- 3-06/ c <br /> �, / City State Zip ' <br /> Property Site Address: -7 L( 5 e o S P£� 7 ./i A aj 2`(r (,v Z 5 c/ 8 3 0 ri <br /> Applicant's Telephone Number: 7 Z v 2 C1 8 2 3112_ X p <br /> Applicant's Email: `C 1'" C.b C 6, c-0 • cA MP. <br /> et <br /> Legal Description of Property: SES A h1' ,(E ct„) ,.....,....:\ <br /> Section#: 20 Town#: u 0 N Range#: 1(D W Town of: Oak.Icy,h CI � L. r <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* G 1� N j <br /> Tax ID#(1-5 digit number; found on tax statement): lq .f.5'1 2> R. N <br /> II <br /> Provide Rental Information o rw <br /> License Year Applied For: l 2 L Amount of Renters Applied For: 4 .2 <br /> b <br /> Local Contact's Name: Oty(f t. j►'71<M (_t /" <br /> 31LZ eiA 35 w£.�57� �2 -q % 3 z <br /> Local Contact's Address: `( 5 (< i" -7 .�1/ 10 %?4uz`, ``� `?C jjo �1 <br /> C2-8. dity State Zip <br /> Local Contact's Telephone Number: ! i S'42 -7 <br /> Most Recent Burnett County License Number: STR- State License Number: \)W AI- G A 5V H 5 <br /> d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO AJ,L,CONPTT1nNS LISTED BELOW: 3 - <br /> z <br /> X <br /> y <br /> rn <br /> F1 Fee Rec:3( J'o <br /> N -4 VV/t ( <br /> Date of staff site visit: ie <br /> e 0 I�'als f si • visit sta f: n <br /> LICENSE APPROVED BY : (1, fr�.i/.�/- 'DATE: /? ` (? . <br /> Q cn <br /> 0 <br /> LAND SERVICES OFFICIAL <br /> if <br /> r- CD W n <br /> �- m c <br /> n 5 <br /> 0c- N <br /> ili <br /> c) <br /> Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application— Rev 12/2020 3 <br /> = <br /> m <br />