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❑ ' <br /> G rt <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI �: ' a <br /> c <br /> Applicant Complete All Sections Below This Line ] g. <br /> CD <br /> Original License Fee= $300 Renewal License Fee (Annually)=$150 r <br /> Property Owner's Name: o ..l ., `j a 5,re.,,,, <br /> Property Owner's Mailing Address: S`Z' F. ,,.'z.ea, 57. 5 •emu,ew M'v S�/?� C N w <br /> City State Zip c ' <br /> Property Site Address: Za tio9$ 5,....r; r r. (�:r s 6��q _. y�yC, g <br /> p N <br /> v <br /> Applicant's Telephone Number: (pt 2-Vie- 9 Ze Ce, O <br /> Applicant's Email: J 4j S 41 s re rre./e_ yu t..a o , c.-'-, <br /> Legal Description of Property: d CY <br /> Section#: 2 9 Town#: 37 N Range#: I Qj W Town of: 1►ram Ae La Ice <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* op <br /> b n N ', <br /> Tax ID#(1-5 digit number;found on tax statement): 2'je/l�.c, :4 <br /> < ..k <br /> Provide Rental Information v, ~ <br /> n <br /> License Year Applied For: Z Z3 Amount of Renters Applied For: �+ <br /> w <br /> b <br /> to <br /> Local Contact's Name: I(`-le."Y S 3s re_rye- <br /> z <br /> c HN- 47. <br /> Local Contact's Address: 960G4 N4,--11, Ir+-[c..d ke,,, 1_ lce b,-. S; e, w r CV.9 L ° <br /> City State Zip N <br /> Local Contact's Telephone Number: 6s1. 7 0 S. 3?`/V 0\ <br /> Most Recent Burnett County License Number: STR- 2.2-IC State License Number: /'l&12.H -i3;�e!u y'. L.\z) =1 5 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS=ONLY b <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -i N f <br /> • / iCPjiS- 1/ 1/2°2 / - <br /> z <br /> • Ni.a8(ifru 6, OCC,t pari4S o - - 1S rca <br /> • 11-c1v ki-VISOV 1- -b k wd.a--c d N 3/ 2023 i, 1 <br /> ' Fee Rec: tj- <br /> Ck#: �g'a <br /> f � , <br /> ,LIE . <br /> Date of staff site visit: 'Z/2�/�Z Initials of site visit staf : C <br /> , ,...LICENSE APPROVED BY : -1k0 2G� DATE: I2/SO/2OZ a ' a ® i <br /> T CO co <br /> LAND SERVICES OFFICIAL a, 5 % cam, 0 <br /> �- G <br /> on NJ <br /> <'' Al t-a C <br /> Page 1 of 3 (' N <br /> Burnett County,WI Short-Term Rental License Application-Rev 03-2022 ��� <br /> x <br /> m <br />