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a Co n <br /> SHORT-TERM RENTAL LICENSE APPLICATION—Burnett County, WI F, y <br /> el <br /> Applicant Complete All Sections Below This Line n. <br /> o B <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 �� c <br /> Property Owner's Name: ANOOP MOHAMED IQBAL NNN rn <br /> 1601 N Adams Ave, Marshfield, WI 54449 ° <br /> Property Owner's Mailing Address: W <br /> City State Zip <br /> Property Site Address: 28175 Ellis Dr, Webster, WI 54893 ° r <br /> Applicant's Telephone Number: 2164031463 m O <br /> Applicant's Email: Amazinghost123@gmail.com I <br /> r <br /> 0 0 <br /> Legal Description of Property: Please see attached v <br /> Section#: 20 Town#: go N Range#: i y W Town of: ,,(} - OJ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* a°ali <br /> Tax ID#(1-5 digit number;found on tax statement): 13 32(0 g c m-- <br /> < p- <br /> Provide Rental Information <br /> 7Z) , 2. p.... <br /> License Year Applied For: 202 3 Amount of Renters Applied For: 4 N q <br /> Local Contact's Name: Chelsea Nelson 4-1 <br /> cm <br /> 29103 Treasure Island Trail Way Danbury WI 54830 z <br /> Local Contact's Address: U <br /> 715-733-0797 City State Zip .0 <br /> Local Contact's Telephone Number: <br /> NWOR-CLESKB J <br /> Most Recent Burnett County License Number: STR- State License Number: N — -t <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE ISSUBJECT TO ALL CONDITIONS LISTED BELOW: F <br /> -Lk ue,ns.e -e K ►reS i3 l I ZDZ�{ �Ol�°t^� q,Q,� tryS n� w 2�w�'-�^ � Q <br /> z <br /> - OccuwanN (ANA acktr-i-isl;vnal+- cAnno4 iv-ad )e_ <br /> - Loc,k C ,nr,( Cih&CAn On . {,plc. +a nk 1 i di(s) o-- U.e,° -i g <br /> `, r o Fee Rec: 3 <br /> � y✓� L / 0i oz3. Ito- ,t- (L. r-t� (ir.Jnsincl rrtur� *S ,- Ck#: ioq.a. <br /> 2 <br /> Date of staff site visit: J 22/2 2ZJ Initials of site visit staff: <1 < <br /> rn <br /> 3 3 l <br /> LICENSE APPROVED BY ]jAJ? —Tr DATE: 7/ 3 ., r- <br /> m <br /> LAND SERVICES OFFICIAL ° n tl U U <br /> sk am o 0 <br /> ( C N Ina <br /> < 0 n <br /> Page 1 of 3 ° N o <br /> Burnett County,WI Short-Term Rental License Application— Rev 03-2022 › s L'.' bid <br /> x bd <br /> m 31) <br /> rt L <br /> m <br />