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r <br /> C4 <br /> co <br /> C . A <br /> et y fD <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI 1: " C <br /> zCA <br /> Applicant Complete All Sections Below This Line d <br /> Original License Fee = $300 Renewal License Fee(Annually)=$150 �-cp R <br /> Property Owner's Name: (J� "' 1' I I i U �•� 1 .1g *i <br /> pMailing Cg'f 7 __.),-/e,/‘; 24," v, rrip 5 3 i'7 <br /> Property Owner's Address: <br /> i City State Zip c ' <br /> Property Site Address: l Z/41 .t /2 L ,Cja v�e� L✓-L �y$O\ t <br /> (,� CD <br /> Applicant's Telephone Number: 6 (Zg 7 V?/ x O <br /> Applicant's Email: /:3 IVO) tt/61-K (AJ'441 /3!i/ - L. 41.^, / / o• <br /> Legal Descri do of Property: (-4)1+ g 6-5/"h V / 247 A d •- <br /> Section#: Town#: V() N Range#: I Y W Town of: 5Gv'f - i' <br /> *Attach additions page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* A <br /> g4(&3 ° E <br /> Tax ID#(1-5 digit number;found on tax statement): 5. � W <br /> 14 <br /> Provide Rental Information <br /> r::) -..1:i. r <br /> License Year Applied For: 2,� Amount of Renters Applied For: / ) - <br /> Local Contact's Name: 'pi,. Fel g <br /> �t2' 3 r y le_cwfl� z <br /> Local Contact's Address: �^� � *wier t� �6 1 � <br /> ( 5 I1 9 v0 City State Zip <br /> 9 <br /> Local Contact's Telephone Number: � <br /> Most Recent Burnett County License Number: STR- State License Number: 6X- I Y4 u 1' <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -3 ° <br /> etialCr L 4c> be ciel fo54cci w,-1-4 Q. #eej <br /> * .r%4P5,3 <br /> laceeat( Ack4 4 <br /> s •' 5 e4°#9 z <br /> ws.,,i,0 <br /> Fee Rec: �� <br /> -&-q) <br /> 8 Ck#: -3/37 <br /> rr, <br /> Date of staff site visit:5/? i?g7� Init j o to, sit staff: u <br /> 7`, Si <br /> LICENSE APPROVED BY : AA,/ A,,..,, AY DATE: 6-420/aa) a to <br /> i <br /> LAND SERVICES OFFICIAL / r co CD D <br /> m m = Na <br /> n y C.u. <br /> Page l of 3 e 4 <br /> 0 = .r <br /> Burnett County,WI Short-Term Rental License Application—Rev 03-2022 <br />