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c r <br /> c$ `g �• <br /> a C <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI I: n Cet <br /> 0 <br /> C <br /> Applicant Complete All Sections Below This Line = 2 <br /> Original License Fee=$300 Renewal License Fee (Annually) = $150 co <br /> gco <br /> Property Owner's Name: O// Jre. <br /> / t e ,..3 <br /> Property Owner's Mailing Address: / 3 r^ v J4 <. ?•, N <br /> p R5i Co,(0-y . A t Zip� R. w l <br /> Property Site Address: �� 3 <br /> Applicant's Telephone Number: 962— 3)2 2 /Z 7 sb % o <br /> Applicant's Email: / o/) M&Ln.1e Q6— / • �Nfl ° q <br /> L o r <br /> Legal Description of Property: PC L �C)V O__ 2 - a R. <br /> Section#: S2?j Town#:T9(j N Range#: R)5 W Town of: ,.C KScr) _ S' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o°o - <br /> Tax ID#(1-5 digit number;found on tax statement): ±J 35 _. < w <br /> 0 <br /> Provide Rental Information c <br /> License Year Applied For: 20 22 Amount of Renters Applied For: G <br /> Local Contact's Name: L f n,JS:N AitT,(1 `� .2P � � j ,r-�� z <br /> Local Contact's Address: J 16 3 L -7 . -L^ 1 J. sue/ y o <br /> City State Zip <br /> Local Contact's Telephone Number: 7i'j — 9 )7 - up�t✓ <br /> Most Recent Burnett County License Number: STR- State License Number. tr Or Q <br /> W }'U ,vD , C <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL C ITIONS STED BELOW• , <br /> d� <br /> 0(J,-kl 1,;d(e (;rtes 1v'eeJ �'�� '� Q C,� <br /> A �lne/ ent Co/1-{c. - ✓I P', nec/ z5(1� e <br /> c4 <br /> S <br /> F.' Fee Rec:It 3OQoa <br /> / zzz Ck#: 1' a <br /> I,�vrn <br /> Date of staff site visit: 6l/✓2 ��� I • al f t is' staff: �! <br /> LICENSE APPROVED BY DATE: 14! // � . <br /> LAND SERVICES OFFICIAL z `— <br /> z <br /> .Ei; 7 <br /> f•` <br /> n) <br /> ......1 <br /> �I <br /> Page 1 of 3 w <` <br /> Burnett County, WI Short-Term Rental License Application—Rev 03-2022 14 "' <br /> pi, m. <br />