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c7.. r <br /> cr <br /> a r A <br /> SHORT-TERM RENTAL LICENSE APPLICATION— Burnett County, WI I: K = <br /> C g <br /> Applicant Complete All Sections Below This Line = 8. a <br /> it cr <br /> Original License Fee=$300 Renewal License Fee(Annually) =$150 A <br /> r - 4-Property Owner's Name: �r G{ P).- Y 1---A' 0-3 <br /> Property Owner's Mailing Address: _ I L- \e J-e R"` S - r( 1P-i C a n( Kr4 3`=: 0 i�a <br /> „ N <br /> City State Zip (V�•1? <br /> Property Site Address: 1 1k 2 I Z ck n �: �„rc�r_ w g <br /> kyl <br /> Applicant's Telephone Number: G k (• l% r 0 l4`-'`+ m <br /> ix g <br /> Applicant's Email: 241 Ylrk.k c k /Y1 Al ( _('o 0 N <br /> Legal Description of Property: % SS 2 9 I r_..,c r, I ., P.r> Lc-r <br /> Section#: Town#: �-\ N Range#: Flo W Town of: 5%v `>> o W <br /> tll ,11. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o0 <br /> 9� <br /> Tax ID#(1-5 digit number;found on tax statement): 3 3 ZO -- ' ZZ I lqc1 7q. 3 r. <br /> Q <br /> Provide Rental Information <br /> 2 W N VI <br /> License Year Applied For: ?0 7 3 Amount of Renters Applied For: - -lam <br /> Local Contact's Name: -ri-U `:•- a -1- � i 1 1 P.-a"-t �'�-t K 0" u's'o aa F <br /> �— z <br /> Local Contact's Address: L LA-1 t Z e C e r ko 6 T.i t\( i5 a �rf S.5-73� N <br /> City State Zip <br /> Local Contact's Telephone Number. -2-A V-. G • C L-34- I <br /> Most Recent Burnett County License Number: STR- State License Number.N W Old-CIJ V n1 CA i <br /> CN <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY N o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: i <br /> -Licerise tx.pi(-es 1 )31f2at( <br /> •Df.Akfcc ru1.l and O dVer- -s-'- t2l-f- not -b -P,),C-eCl LI 12e ap le z c., <br /> -Cbc.k cla c lACI:lA Del Ste(C. (0- all --hM,e <br /> -K.e r ,t ' A-i cts-LI Vs -b k poste n:e, v nnc n u -/rrtoce <br /> (P 1 /zo23. L Vt*-' ti) 4 Ll G2f'1 Sl t Ceprt.. Fee Rec: <br /> T/1u cU-e 1t co.2nsi re wrens Ck#: 3�4 <br /> Date of staff site visit: 31ziU)z3 KT <br /> Initials of site visit staff: ,, <br /> m <br /> -7 LICENSE APPROVED BY 11(,y DATE: ` 1l1Zo23 c.,1 ( -- <br /> LAND SERVICES OFFICIAL 5 a ` �f <br /> ‹, CD 33 Z c <br /> m <br /> m » — UU <br /> d o G a = <br /> Page l of 3 1 N <br /> Burnett County,WI Short-Term Rental License Application—Rev 03-2022 1 ``' <br /> R. <br />