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AS,VCIP P v) r r <br /> p A <br /> Ci SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI : °I 0 <br /> c <br /> Applicant Complete All Sections Below This Line <br /> d g <br /> Original License Fee= $300 Renewal License Fee (Annually) = $150 \ ro <br /> Property Owner's Name: C-Ap t' U i Om✓r7 y <br /> Property Owner's Mailing Address: 37 P,. 'r , : °< N <br /> City State Zip g <br /> Property Site Address:4 3'I0 41n))i ) 1,,, J i, t p r tor 5 P5 11` <br /> g to <br /> Applicant's Telephone Number: 'li ,-(14 Q $ x p <br /> Applicant's Email: i nee t ra ci NC1 i; CO 01 <br /> pp � ��"� t�@ es 1 , r o� <br /> o cP <br /> Legal Description of Property:Saf_ 34 T� 4 0 R, 1`7 Lo\-I1 C fl V 511 13`g d <br /> Section#: 51-1 Town#: 9 0 N Range#: tic- W Town of: at :. ....C. <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 /> n o <br /> Tax ID#(1-5 digit number; found on tax statement):—14 Id I (�59 '' N <br /> C -. <br /> o_ <br /> Provide Rental Information ^ � � .1' <br /> License Year Applied For: 9n1,3Amount of Renters Applied For: if , ,� <br /> k - / -0 g �n <br /> Local Contact's Name: L,>V piLlr'O o - Mrt r1 ov-4 \ o0 <br /> V, , z <br /> Local Contact's Address: Aov U or ' 0. m B L dL , ` a <br /> ul <br /> City i r ate Zip ooOO <br /> Local Contact's Telephone Number: a Cy,V LiORSpit•9,a0-o3,,.9 <br /> N � <br /> Most Recent Burnett County License Number: STR- State License Number: . . • -r._-r._ P W N ,x <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> .-i F cp <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: g <br /> Di' 016- <br /> CI r LL .is Ku4tci TYti(1' 1 l►cuts 1(1°) t-tv,1-1 re A-e41 , { at+ <br /> yeah k CIIK,iFi bYl• <br /> O Cowo1 OkOVAII-Cd -=or M/Ort --N .n 12- fit. . `� <br /> /I c � �p ,, o <br /> � Fee Rec: <br /> 3$152- <br /> Cof�Y' — J a L U,. - mm+ h� 6)J /ZO2 <br /> o Ca 64.20 <br /> !2Il$/20zz /Date of staff site visit: Initials of site visit staf: < <br /> LICENSE APPROVED BY DATE: f 21bSiZ 22 <br /> Ofil <br /> LAND SERVICES OFFICIAL . a <br /> CO co rt..' 0 <br /> 6 0 C! I—"1 <br /> - v o "' c <br /> Pagelof3 <br /> _ 8 S .; c4 <br /> n r <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2020 - 1Ifiii <br />