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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r <br /> _ CD n <br /> Applicant Complete All Sections Below This Line a 0 y <br /> Original License Fee= $300 Renewal License Fee (Annually) $150 1 ,- E. a <br /> d <br /> Property Owner's NameT tC-(AL. (, A (6I A Ir" :: a <br /> " 9.5111 �tt1�6 l�l �•n VG <br /> Property Owner's Mailing Address: a cdczz.►►''``.i� (5 '& <br /> �L2 City Stiie Zip CJ <br /> Property Site Address: T � ("(,�y(� V t h v-� � � 0 N <br /> w <br /> Applicant's Telephone Number: '.31V;b—'�' 3,5".- g: r F. <br /> Applicant's Email: /,;y%;� 101 1'Gk(.t1 �aCr�k. e!�C1 1'Yl9tt a <br /> **If staff has a questio a.o Ors"application,you will be contacted via email. Make-lure your email address is b O <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and g <br /> @BurnettCountyWl.gov II ` g R. 0 <br /> Legal Description of Property: 'r�//--C V e p2 I M`' �� W t �) d <br /> Section#:_ J Town#: N Range## (SSW Town of: $co 16 5 �' <br /> I <br /> g. - n <br /> *Attach additional page if needed fo lengthy description OR attach a copy of the deed OR attach tax system property page.* rg� -� <br /> G n o <br /> Tax ID#(1-5 digit number; found on tax statement): a-t b i ' A <br /> 0 <br /> Provide Rental Information <br /> License Year Applied For: .2.4 (2-5 Amount of Renters Applied For: t <br /> a , <br /> Local Contact's Name: A On 2 _. <br /> Local Contact's Address:36�(p g 1tct )bk..tlSah K.d& . \ . j�' uJ't' b o <br /> �i City v State V <br /> Local Contact's Telephone Number:(--11 S� 33 - I o i,5� <br /> �L c, J <br /> Most Recent Burnett County License Number: STR-2.-5 f State License Number:"DW rT I •- 6),L(> oN <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY --P E <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: y — <br /> -Liaatlets t ) 31 /2a2y <br /> - Oda r oo 0.aw ' -t- not- -I-o -e.x u-LcA C.12 p o p- -'- v <br /> SAN - ►1 -209 <br /> - e�,n-I-cl� U,�c�,t/;,,�.% AD \ U�C�.ckve-d �.{ `I I IS J2bl bC o c�, BulAi14 = vh <br /> Cc uA Lunt Nu,mb.l,r,`1)kkr&L2+l- Caun-k Cc n+acc, Fee Rec. 150°5 <br /> z Ck#: Z250 <br /> A Bid Qenk, <br /> m P:-)p`v};es <br /> Date of staff site visit: 127/2013 I tials of site visit staff: ]eI o <br /> z a 11'� <br /> c� <br /> LICENSE APPROVED BY DATE: / �/ 2a2.3 m s= <br /> LAND SERVICES OFFICIAL m gi <br /> 0 o c r`� <br /> Pagelof3 -4 — R ,G; <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2022 i g `"' n <br /> rn <br /> 11 <br /> m �: <br /> z <br />