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a N eeD <br /> SHORT-TERM RENTAL LICENSE APPLICATION— Burnett County, WI I: `° = <br /> tv <br /> Applicant Complete All Sections Below This Line = c'- <br /> cp <br /> Original License Fee— 0 Renewal License Fee (Annu4l1y)= $150 '" �; Cr <br /> i <br /> Property Owner's Name: CJt '.w / - - (�V ', ,,„� <br /> Property Owner's Mailing Address: (p S `h L �� _- (,� CJS Ar--n'---- o Is N <br /> ,(( / �) State Zip � ,� � <br /> Property Site Address: 50-Z 1" ( 5 ) 7.3 '" r ,. <br /> q § °9 <br /> / <br /> Applicant's Telephone Number: t 0 z.2`.:63 '73 / e ' <br /> , o <br /> x Applicant's Email: C'`eAr0-- \.1( 19 j (- �1I 0m� P' g <br /> _.j_ C 1 ,, / r�� ' 8. <br /> Legal Description of Property: -rk 1 ,T S-j 1J�ritJ /y zs' 1 I(P-:J /--+ d <br /> Section#: 0' Town#:37/\l N 1�g#: /4)1 W Town ldf; P__�ypN, EY b� J o " � <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* a ` ' <br /> d n5 <br /> Tax ID#(1-5 digit number;found on tax statement): 3 qv,26 5. c W \ <br /> Provide Rental Information c cn <br /> .b <br /> License Year Applied For: 20Amount of Renters Applied For: Qv)(A j4 <br /> Local Contact's Name: QM � ( Ric:r _ w 11 <br /> . <br /> ( z <br /> P <br /> Local Contact's Address: k-Tre_. (5 _4'Q_- <br /> ty State Zip <br /> Local Contact's Telephone Number: 5"G� (j 7,7\z } 73, t <br /> Most Recent Burnett County License Number: STR- 2---1 1 10, State License Number: /` I V� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY H c <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 'o 4 n'7 O1;31 i' (en s eN '.6 <br /> _ Uz i� N <br /> 0 <br /> S <br /> ,74 <br /> e Qo <br /> r Fee Rec /C <br /> �8Ck#: 1o 51_Date6 of staff site visit: / O2� I 'ti. I site 'sit staff: kiL <br /> a '/ <br /> Cil <br /> LICENSE APPROVED BY r� <br /> .� DATE: 7/7/).1 <br /> a <br /> LAND SERVICES OFFICIAL / g; r <br /> <rca <br /> ,54 <br /> a,m N <br /> - <br /> ' <br /> CD r,.)w ( <br /> t g <br /> Page 1 of 3 2-4 ^' <br /> Burnett County, WI Short-Term Rental License Application—Rev 03-2022 1 <br />