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c r <br /> a a n SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI N: ' e� <br /> rn <br /> G A <br /> co <br /> Applicant Complete All Sections Below This Line ,- °- <br /> d g <br /> Original License Fee = $300 Renewal License Fee (Annually) = $150 "� <br /> Property Owner's Name: 17>A..‘? \t\i , C A,ZR e7`, (.__ K4,2.4144I�Q ? <br /> Property Owner's Mailing Address: ZZ 6„?O 5c v I L'Ie (., 5 ti?• W ., 5 484o 0 <br /> City State Zip cr. <br /> Property Site Address: 10055 S I i--V e_. L Lit), /C� � i \ / t 5}04G <br /> ii <br /> g d <br /> Applicant's Telephone Number: 5-0 5.7 rn p <br /> b f <br /> ✓ Ci-QCt <br /> Applicant's Email: �2lzOl.(_/UlAlL�� � , �� R <br /> Legal Description of Property: 1..El-Z C-54v1 VZ k of (.4 41'\ 1..., -Z) d <br /> ro <br /> Section#: 6 CP Town#: 3 b N Range#: 'J W Town of: v,t.'3 Ali Of' i' 1‘ — a- <br /> *Attach additional page if needed for lengthy description OR attach a> fco,jpy of the deed OR attach tax system property page.* N ^1- <br /> Tax ID#(1-5 digit number; found on tax statement): 9'�t''l'S (0421--Z) 3. c) o , <br /> or <br /> Provide Rental Information - w ri, <br /> License Year Applied For: "6 Amount of Renters Applied For: Ll�P T Mid,' w c& <br /> - n <br /> Local Contact's Name: Ve- CAkiZOL,L -0 <br /> ao <br /> g. �' <br /> Local Contact's Address: <br /> Z&6C% `r. 5 t L-1/( L V (24P CI,2'-1ng5 �,�Z6q ,- ° C <br /> City State Zip <br /> Local Contact's Telephone Number: 450.7 '7 't ` OLT 57 � 7 p <br /> Most Recent Burnett County License Number: STR- State License Number: I,I`444 L^3- y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: a e NI <br /> —Lt Cent. exeore,S t 13(J2Dzq <br /> - du.u,panv.1 0,1141 act ve r-l-i '.rne-n+- wok -lam -ekC 2-1 pe,opu- z <br /> ,�° ? <br /> L- ock coot divAA n ea fi'c- a+ 01,(,l -f-i w--- ", <br /> b.{ (o 1 I/zo23 N -, <br /> -6) ,Q svU c ►'ems 40 fie, 1%4.td bk{ MOAil U f alle--e o <br /> m Fee Rec: <br /> (l C-(--4. L cr6 1.1 CJ-►1s i nC) ,+re-me'n'l-S <br /> 6 <br /> o Tow Clc#: 3�- ? <br /> - all Li m "-5 n <br /> Date of staff site visit: 1 Z f 312DL2-- Initials of site visit staff: ACT A n <br /> rn <br /> n C <br /> LICENSE APPROVED BY fil6f):47-----49DATE: ( !S/ a3 <br /> IE ^ O( <br /> a 0 <br /> LAND SERVICES OFFICIAL ? m co cl <br /> cl <br /> ;< 2 3 <br /> R m0 (-„ <br /> m pp = <br /> '$ 1 O <br /> Page 1 of 3 v =.� INJ <br /> ff <br /> Burnett County, WI Short-Term Rental License Application-Rev 12/2021 › w <br /> I <br /> rn <br /> L� 1.1 <br /> rn <br />