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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r r <br /> . — <br /> p'• CD A <br /> Applicant Complete All Sections Below This Line <br /> = C fD <br /> Original License Fee= $300 Renewal License Fee (Annually) = $150 a a c <br /> Property Owner's Name: Ara.ly�. Jo.r,/ ,••e,.� Cr <br /> Property Owner's Mailing Address: -7 v ct ltt/4 Ave. 5 M r,.,eaci,.1,'., M/" c5 07 <br /> City I State Zip <br /> Property Site Address: '2:3 q 4- A zo r0.1-v L.-Le, 5 4e-11 L0.(-e, I 5-1715?Z 1 o N <br /> .6l � - 4 r� w <br /> Applicant's Telephone Number: -7� Z� ° t- lls <br /> co <br /> Applicant's Email: --)A R V j2-,cA)TS Ct/tl.4 t L, Co.--1 <br /> CD <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is x 0 <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and =t <br /> @BurnettCountyWI.gov 5. <br /> P <br /> Legal Description of Property: i -t'T / C S PA J Z. P 2_5(8 d qp <br /> Section#: / Town#: 3 B N N Range#: /Li LA) W Town of: ' i,,)E� 0 <br /> `b <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* tq -- <br /> n N <br /> Tax ID#(1-5 digit number;found on tax statement): 3 2_c / 5. A .!. ``� <br /> Provide Rental Information 4 iv <br /> License Year Applied For: �`7Z� Amount of Renters Applied For: 't` N $ S' <br /> b 3 <br /> Local Contact's Name: /7��a,�c 5 le_;-,.mac �-Z z <br /> / <br /> Local Contact's Address: 7 5-7(�/,J %�ve_� -d A oa-K ( W/ CV?7•Z iv •_ <br /> City State Zip <br /> Local Contact's Telephone Number: 7I 3 3`rj I / 9 5 I civ <br /> Most Recent Burnett County License Number: STR- State License Number: Ps.L ) Z, —C Ti#f-J <br /> a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 3 <br /> - ucrime -NpiaS 1 J31 /2024 <br /> - R.e,n-k i- 03 w aiwt ae�S 40 be- pbs4-eel A,ta.r VYLCAA r\ t Yt n-C-t-ca- z <br /> 61 53 I t 12 )23. S-e-e. I-e.-k-tr (1-> Of) Lice-rnn 1 rn P(LC"re'"& ,i--5 <br /> o <br /> m <br /> r Fee Rec: <br /> .tow o Ck#: j(>, <br /> - A1� LA Ce lS►rtiP etc u r t rn,a r-K <br /> x, <br /> Fi <br /> cn <br /> Date of staff site visit: 1/ 2-023 Initial of site visit staff: 1-- <br /> n <br /> - hrli <br /> -) r E v <br /> LICENSE APPROVED BY DATE: (¢'ZO12�23 ` .< 3 20 <br /> CD a ind <br /> LAND SERVICES OFFICIAL o o ccs <br /> < o a tv <br /> c= <br /> cc <br /> Page 1 of 3 ° 1 <br /> Burnett County, WI Short-Term Rental License Application-Rev 12/2022 <br /> x J) <br /> m <br /> 70 <br /> cn <br />