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r o r. <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI - ° ' <br /> . <br /> F CD <br /> Applicant Complete All Sections Below This Line p a <br /> d i <br /> cr <br /> Original License Fee= $300 Renewal )License Fee(Annually)=$150 U, <br /> Property Owner's Name: p�C,l{eu ) , u„, id f 4 i,-,e$cs... ill Ross' ' U \ v' <br /> j. ,J , f o <br /> Property Owner's Mailing Address: 7 7q 1'1t(yc•Q r Drttis� b 4„ �'Y tf ris w <br /> City State Zip ' <br /> Property Site Address: 7 8" i/i Rd 0 G e,h ) r i i S'y te a F —P <br /> Applicant's Telephone Number: . fD <br /> Pp P 7/ c— L®tf ��� S rli O <br /> 1 �' b <br /> Applicant's Email: r,'CI-t.&l1dlL rfi• 61 c.eri4 vrr l-. . l ,he, hei 5. g <br /> Legal Description of Property: alesV 71 �� /0 o <br /> Section#: / e Town#: 1 G N Range#: /. W Town of: —I:4C k )'1 <br /> 0 <br /> *Attach additional page if needed for lengthy description OR a':ac/i a cop-,,of the deed OR attach ta,:i system pi operty page.* <br /> d cn c,� <br /> Tax ID#(1-5 digit number;found on tax statement): 7 ,b 4 F., ;� <br /> Provide Rental Information 1 g ,°j II:P <br /> P es <br /> License Year Applied For: )iC.Z. Amount of Renters Applied For. �• �Iy• 7 _ I S <br /> Local Contact's Name: R , .ITV Rv_SG2 i- 1 -° 2 p,7) <br /> 1 z <br /> Local Contact's Address: 2 IC - c pi G sect- 05 Ltia- yc i ' t A/1 S4 93 0 <br /> City State Zip .WL� Z <br /> Local Contact's Telephone Number: T7 f c- c vt, - I( <br /> NW OR- G `Qgsw$ - I�Most Recent Burnett County License Number: STR- State License Number: D, <br /> 00 r. <br /> A.RFA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLYI le <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTE BELOW: <br /> W <br /> 0 /VPt 74 ie © e-eq cr S CI WI 0741/G1 o /D <br /> b+1 w i ©u f -c <br /> o y � <br /> a ire ? c . /A'S /S ot She L,'ly eltAl�1,,9 � <br /> P L <br /> 0 A)o7 exc'f-e c/ aln °CC-11" ee /R be“c off. G <br /> 1ft <br /> p W <br /> 10 - $ l �r w, ► - �/ire 5 D IA //3//2� Z V. ' <br /> 9Yl be r -ime U �y 7/// Z 3 . Fee Rec:�[��c <br /> zz Ck#: o�3 <br /> Date of staff site visit: f2tO/2O2 2> Initials of site visit staff: < <br /> LICENSE APPROVED BY DATE: W2.o as.3 m' <br /> LAND SERVICES OFFICIAL 7' m co 0 <br /> A A m i <br /> m � .... f�� 1i3T 1�157111 <br /> 0 c <br /> Page l of 3 <br /> 3 w <br /> Burnett County,WI Short-Term Rental License Application—Rev 03-2022Ira <br />