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SHORT-TERM RENTAL LICENSE APPLICATION - Burnett County, WI : <br /> rB <br /> Applicant Complete All S rations Below This Line _ a c <br /> Original License Fee= $300 Renewal License Fee(Annually) = $150 1 I c <br /> ll h- . <br /> Property Owner's Name: DGrt4L- 4- 1ll__�1 Sc ,J4 e,-+ = N. <br /> �33 ti 81-4 rk Tro d 'or- I\'1 N ,�S tI v n P 70 L <br /> 11.3 <br /> Property Owner's Mailing Address: ° <br /> � tt T City State Zip r I W i� <br /> Property Site Address: • -9 40,5 a H4 n 6 Go fi k[- )rA:I Via L, J�Gn ry wI, 5183 a - 9. i <br /> 1r `�D <br /> Applicant's Telephone Nurrber:_CZ1 o- 3/S) .1 ,re,k_, -- ,,, 0 <br /> v <br /> Applicant's Email: 5 C.)ub I 4'-I e? kiOhoo • CAS i <br /> �� (PO r 61 N ggsC , L T(4:1 V V� o 1-C:Legal Description of Property: 4 � <br /> Section#. 7 Town#. N Range#. 14 W Town of:_Cf0 tt_____ —_ V + I Ic° <br /> *Attach additionalif needed for lengthydescription OR attach a of the deed OR attach tax propertypage.* l� <br /> page Pt• SPY �n <br /> o N Ifil- <br /> Tax ID#(1-5 digit number;found on tax statement):��3 0�__— <br /> Provide Rental Information I �, I6' <br /> License Year Applied For: 2-6 2 — Amount of Renters Applied For: q to g c <br /> Local Contact's Nameje/Pik- ,SG I 07 <br /> jl� <br /> Local Contact's Address:3&5`1 5--k4 --Pro(per k 6.540 IFP <br /> / ) City State Zip I.� 1 - <br /> Local Contact's Telephone Number: LL, zio 'a)5) 1`^ <br /> ,, —1` 1 <br /> Most Recent Burnett County License Nunber: STR-_— State License Number: J a� �r 6I N\ <br /> - A o r" V <br /> - o <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY I THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -' 1._� <br /> LUL a �N I(M l� V+ t 1, d �t�w c c, 1{S Ul <br /> w <br /> — LiWitc-f -e 612/.14f 1 /3►)2 2 <br /> —0(.0,426A I i m4 041 Kot-(-tux Pak( Placard `to dA frl1 <br /> 10 P'eaplr •-i-0 y 7L by 1////2023 o Fe ec:aOh� <br /> 1 � <br /> Date of staff site vit: ` I I 7V/2013 — Jnitia f site visit staff: --_ 5 <br /> m <br /> LICENSE APPROVED BY t E: I/4UZ3 — co <br /> D C7 <br /> LAND SERVICES OFFICIAL ? E , Ififil <br /> a FR 0 <br /> m m W <br /> m S.= <br /> Pagel of 3 -I <br /> o <br /> Burnett County, WI Short-Term Rental License Application— Rev 03-2022 m '� Q <br /> x 3 <br /> mlia <br /> m <br />