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v, r- r. <br /> -. al g CDCD <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> 5 <br /> Applicant Complete All Sections Below This Line 2' q <br /> d E <br /> cr <br /> Original License Fee=$300 Renewal License Fee (Annually)=$150 b- <br /> "2A6 �%-C� (IV- 6ihdty M,LGI�Avy. <br /> Property Owner's Name: W dj a .-,. , i <br /> '?��OS 4. 1 v�caC In C7\-w�( M,,�1 S M z <br /> Property Owner's Mailing Address: < N <br /> • N <br /> .} \� , Ci State( Zip p r ' <br /> Property Site Address: 2� �o \ \ 1Vr 1 L \`(� 4'� / \ �� 1 Q, o I� F <br /> Applicant's Telephone Number: tell- - 2`12 - 4 Li-z-1+ S 1 V,3o P <br /> Applicant's Email: w, S C O 10 Gl 1 c L k-F-e Mat 0. .c ov," j t� a w. <br /> 9. adaroti,t, I I n <br /> Legal Description of Property: `! 2" I ��� Worn- " ��1 t7 <br /> Section#: Town#: N Range#: W Town of: c7CA., \\7L Vy l kJ( mkt <br /> J7 <br /> *Attach additional page if needed,for lengthy description OR attach a copy of the deed OR attach tar system property page.* <br /> — <br /> C7 N <br /> Tax II)#(1-5 digit number;found on tax statement): 4 <br /> A?t•-.C15 LI oProvide Rental Information "Q C„ <br /> G <br /> License Year Applied For:/'2-0L.�' Amount of Renters Applied For: r <br /> C <br /> ,..:X/r *-------?e12 <br /> Local Contact's Name: FA1-Gk2Ga-V -u <br /> c, -. <br /> Local Contact's Address: <br /> W4111OZ (, ,KA inolkWI z <br /> 1.--f4 <br /> � City State Zip <br /> Local Contact's Telephone Number: 1 ' '.. ---'10 " - l O <br /> Most Recent Burnett County License Number: STR- ry l+N State Lic;nse Number: OW "c- ,E_ 6 <br /> 5`� <br /> ARE!,BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> H THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: F <br /> fI 0 <br /> 5C05C "5 0/I t r, I a bec r 0"s S� s <br /> 4741 <br /> LI <br /> P c44o le_ 4 be_ re, --kr . z <br /> V <br /> -i <br /> z <br /> F-'. <br /> cfJ <br /> Fee Rec: 0' <br /> J o Ck#: i.O C) ,ta, <br /> po <br /> Date of staff site visit: 6l , v1 I • is o it staff: <br /> Fi <br /> LICENSE APPROVED BY : a - ' DATE: b/�(2-? <br /> LAND SERVICES OFFICIAL r, <br /> m i(i{i <br /> a <br /> Page 1 of 3 ° $ <br /> n N 0 4.0 <br /> Burnett County,WI Short-Term Rental License Application—Rev 03-2022 -i . a' C <br /> m 1 Niv <br /> Aga <br /> m <br /> 10111111111.)'' <br />