Laserfiche WebLink
er".g ..-. <br /> et <br /> SHORT-TERM RENTAL LICENSE APPLICATION—Burnett County, WI y: <br /> y c <br /> Applicant Complete All Sections Below This Line ° <br /> d @ <br /> cr <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 fir—Fi <br /> �! <br /> Property Owner's Name: /: coy r I/1 1g y ,' • <br /> Property Owner's Mailing Address: B1�J a`s,1. _ Av,e. S/ e,vl r ..c'• ti e° N ht u <br /> IN w <br /> �l J City State ip o <br /> Property Site Address: rf u7t ►1(/r rive, v,1- t✓1/ I {.4)1 44o 3() <br /> pp Telephone (612) 2 7 9 _- <br /> Applicant's s Number: <br /> 0 <br /> Applicant's Email: i 1 n h y r- o.rp i Iy p!'h/t'n h A 1 I , c 0.? o. g <br /> Legal Description of Property: fir' S C S M 10 1 y p Zy ( G�v Lot 0 �c <br /> Section#: Z Town#: a N Range#: 47 W Town of: Lipp,lr, �' OA <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* co <br /> 0. � o <br /> Tax ID#(1-5 digit number;found on tax statement): 25 C?)2_ g E' N <br /> o N 1 <br /> • <br /> Provide Rental Information <br /> License Year Applied For: Z iQ 2.7 Amount of Renters Applied For: —L ,5 <br /> Local Contact's Name: Lc 4nc i, iV is A- i <br /> C' 11V 0 <br /> Local Contact's Address: A I l 1 t. ti..Oil) �c 4y,$. V i _C I c..t Li{ , v✓1 9/ t l( —• <br /> /, -� , City State Zip <br /> Local Contact's Telephone Number: —1'6 Cj( ,( L-9 LI- <br /> Most Recent Burnett County License Number: STR- 5 .1{ rim tate •License Number: Dlll)n ` C 147. 1 G N w <br /> x <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ,z k3 (-5) <br /> y N <br /> • Lc nd c,KcAn 0n -#;c ov / I /2o�3 ct <br /> 1,3 <br /> • N\6ty,Weu r CW.1)19,V1 & 3( -l''t S e titn. 'l S Li MAL . <br /> •u e out ()Lataid m V <br /> (51 <br /> r Fee Rec: X- <br /> Ck#: )Jal <br /> tt <br /> XI <br /> Date of staff site visit: ) I I -d I C/ (/ Initials of site visit staff: 1-14::::- $ <br /> __ ar <br /> LICENSE APPROVED BY : DATE: /2/30/20z u, <br /> LAND SERVICES OFFICIAL ^ <br /> a <br /> z3 <br /> Page 1 of 3 'g gU r <br /> Burnett County,WI Short-Term Rental License Application—Rev 03-2022 i o? r.i 2 <br /> g 1 1Fril <br />