Laserfiche WebLink
SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI v, r r <br /> Applicant Complete All Sections Below This Line ` co p <br /> g <br /> Original License Fee= S300 Renewal License Fee(Annually)=$150 a a <br /> Property Owner's Name: <br /> 11 '(4(fr-‘ 13 6 i Cte✓t`)C--) <br /> A <br /> q:?y2 l ir �� y :, <br /> Property Owner's Mailing Address: �� J � �`� y <br /> �/; rty State Zip <br /> Property Ste Address: ` ;) I 2 l7 (1 w il /a ,..- ,,w"1.ef- c-r 5 76(1 c N <br /> w <br /> Applicant's Telephone Number: I ? 3 2 o <br /> Applicant's Email: l3v / Gnu-; Fil /3;cii3. d E. <br /> C l w`' ~ <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is rri o <br /> 43 <br /> legible and your email provider will accept emails from the following addresses:@BurnettCounty.org and ?:. <br /> @BurnettCountyWLgov r �' <br /> 0 A if? � Z-3 ° <br /> Legal Description of Property: L ( S <br /> Section#: �� Town#: � N Range#: ! `N Town of: v'�-�- 5 <br /> S. I w <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* Q c <br /> Tax ID#(1-5 digit number;found on tax statement): �. � <br /> A <br /> o <br /> Provide Rental Information cn <br /> License Year Applied For: 2-4) 2<3 Amount of Renters Applied For: ( i <br /> ro <br /> Local Contact's Name: 1 ' I'_�Q <br /> /N`r 4° g G <br /> Local Contact's Address: 4 <br /> City State Zip <br /> Local Contact's Telephone Number: b t 2 c /c,1 pzio(i �i <br /> Most Recent Burnett County License Number: STR- State License Number: ' �'�r fi P <br /> d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> -Lifer e_ tki )reS ` l3l JiD2 l a <br /> - 0 p a0 o tdiwyt n - ►�-�- -c -x ►s y2 L z <br /> Wpm,/ w <br /> x <br /> Liccrl,c‘rn AeFO1WW o eutucti-vaveird I, <br /> r Fee <br /> g Ck#: <br /> m <br /> < <br /> Fi <br /> N <br /> Date of staff site visit: 5/i l 2,0Z3 Initials of site visit staff: <br /> '— <br /> LICENSE APPROVED BY : a ti SIDDATE: 22 202 .< n 3 ffil <br /> LAND SERVICES OFFICIAL <br /> m W 0 <br /> o MI <br /> Page 1 of 3 <br /> 0 co _ <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2022 , C. C ^" <br /> �� N <br /> (� <br />