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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI ,, t- <br /> CD A <br /> a � <br /> Applicant Complete All Sections Below This Line 1 ,, p <br /> °a a m <br /> Original License Fee=$300 Renewal License Fee(Annually) = $150 8. <br /> Property Owner's Name: © YY1 to VI 1 �kn h S o n o E <br /> , 1 es <br /> Property Owner's Mailing Address: I I t-} tl✓ 'CG <br /> 1�ico'C B V CI Cii t <br /> SU,n V 1 S Li t IC 0 OC 1-3 1,7q -vc^4- �e i''' City State Zip 0 ,7z <br /> Property Site Address: — �' C� �l� W Q rpS��f t 1�J I S �6 ,3 N <br /> j w <br /> Applicant's Telephone Number: _(,S I — \L/,G/ -7 J 3 9 5 g F. <br /> Applicant's Email: e�Yvt u l8 --:3'lO V\✓l So YI e kt -vv c t , c 0,v' 1 <br /> v.) <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is m o <br /> legible and your email provider will accept emails from the following addresses:@BurnettCounty.org and 5. P. <br /> @BurnettCountyWl.gov $ <br /> Legal Description of Property: L.* (, V Li --PI o,--1-- l O A--. 1.1 a C <br /> Section#: C L1 Town#: 3`b N Range#: I C W Town of: Lek F-O I i Pti-e., N r:.�'*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 0°° c 11. <br /> Tax ID#(1-5 digit number;found on tax statement): 3j a 5 3 \ g < <br /> to <br /> Provide Rental Information <br /> License Year Applied For: a O R 3 Amount of Renters Applied For: <br /> Local Contact's Name: MCi V lC B Y t t Yl he✓ r /Vo 1 l u f n 1 / ( Co w 1. • <br /> Local Contact's Address: fV I( ✓- I CC `/$f 3/�4/Itt, Stat A . 1- 191 N • <br /> 3� City Zi <br /> Local Contact's Telephone Number: (p 7 — as-(, J©J <br /> Most Recent Burnett County License Number: STR- State License Number: <br /> -C Licatil <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: '-3 N., <br /> lACk ant alaitn iyi %e-l-ic aT (LP 41(vt,e 0,1 (s).,1 <br /> z <br /> p. <br /> ,t+k( L6 'tS thd bl nol- \1-ears k nspee,+161 i �-e- 1A6t/I ►rz5 0) <br /> FA <br /> r Fee Rec - <br /> d Ck#: 3� <br /> — bi WiSf tYtal'Q 1 /5)/2-02LI „, <br /> rn <br /> u, <br /> I I � <br /> Date of staff site visit: 11 t a j Z.D2-3 I itials of site visit staff: .J,l 4— E o r <br /> � a <br /> � <br /> LICENSE APPROVED BY 4 DATE: 1 ho)�U23 u co rri <br /> cy <br /> LAND SERVICES OFFICIAL "a . - iiii <br /> Page l of 3 o CD C N) o <br /> Burnett County,WI Short-Term Rental License Application- Rev 12/2022 i §` r' <br />