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ADDITIONAL PROVISIONS <br /> • FAILURE TO COMPLY WITH ANY OF THE BURNETT COUNTY CODE OF ORDINANCES MAY RESULT IN <br /> IMMEDIATE REVOCATION OF THIS SHORT-TERM RENTAL LICENSE,WHICH WILL CONSTITUTE AS A <br /> CEASE AND DISIST ORDER. <br /> • THIS LICENSE WILL EXPIRE JANUARY 31st,264. jL <br /> • BY SIGNING BELOW,OWNER AGREES TO ABIDE BY ALL SHORT-TERM RENTAL LICENSING <br /> REQUIREMENTS <br /> • THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT TO ACCESS AND/OR <br /> REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT. <br /> I (owner) declare that this application (including any accompanying materials) has been examined by me, and to the best of my <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information <br /> contained in this application (including any accompanying materials), and I further declare that I recognize that this information <br /> provided will be relied upon by Burnett County in determining whether or not to issue a license. I accept all liability that may be a <br /> result of Burnett County relying on the information I am providing in this application. I acknowledge that I will abide by all <br /> private/public covenants,restrictions,leases and easements which may apply to this parcel. I agree to permit county officials charged <br /> with administrating county ordinances or other authorized persons to have access to the above-described premises at any reasonable <br /> time for the purpose of inspection. <br /> ---ADDITIONAL COMMENTS FROM OWNER ALLOWED HERE--- <br /> A nz. SQL i 1 r <br /> �' Luc- o r ��el� b��r� l.�i�V� ��k.i e 60.1v2.1 in- �av <br /> 0-c'ti'1 - '1Gt - • <br /> LP° reAiCi a-CC ( . C + w-tZ,r '-'.va << <br /> 0 m 11 lr* CIu*ly l Lkc )%yl (.0- t.D„42. s=15 <br /> 'M`c1^ L i�5 ��ia �"Q)C I-6 .1115-4V in+5�'t- i 4iC-sty C * sOl�m\-1-4-ki <br /> 0014\1 Yi'1€A 1 i t r\ a r`r l CAD VlAiLi 1 i rti� `r-. <br /> OWNER'S SIGNATU : 6-7-�L� <br /> (DATE) <br /> Property Owner is required to sign and date this application. <br /> SUBMIT COMPLETED APPLICATION,MATERIALS,AND FEE TO: <br /> BURNETT COUNTY LAND SERVICES <br /> 7410 COUNTY ROAD K,#120 <br /> SIREN, WI 54872 <br /> APPLICATIONS WILL BE ACCEPTED VIA USPS,ANY STANDARD COURIER,OR IN PERSON. PARTIAL OR INCOMPLETE <br /> APPLICATIONS WILL BE RETURNED TO THE APPLICANT.NO EMAIL OR FAX APPLICATIONS WILL BE ACCEPTED. <br /> ONLY CHECK,MONEY ORDER OR CASH PAYMENT WILL BE ACCPETED. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED <br /> AT THIS TIME. PLEASE,MAKE CHECK PAYABLE TO: BURNETT COUNTY LAND SERVICES <br /> Please call the Land Services Department if you have questions. 715-349-2109 <br /> Burnett County,WI ordinances can be found at: http://www.burnettcounty.com/index.aspx?NID=1043 <br /> Page 3 of 3 <br /> Burnett County, WI Short-Term Rental License Application-Rev 12/2020 <br />