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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI VI r- <br /> n <br /> Applicant Complete All Sections Below This Line 0 p <br /> C c <br /> Original License Fee= $300 Renewal License Fee (Annually) = $150 a. <br /> d <br /> c <br /> Property Owner's Name: C.)1Y1Ou P&) <br /> f. 4ACL1 <br /> f <br /> Property Owner's Mailing Address: 16 5% I-1-A lc' in I V1p-y, el f j i p c, tpL '` 9/ . <br /> City State Zip y <br /> Property Site Address: 2 2 59 (c.t lc •py 1 6-071 C{- D a-..h AAA Li fr zj g 3 b o <br /> < w <br /> Applicant's Telephone Number:1 5 - 5 i cl -Z 7��d C 1 (5 --D`i�l -- z.yi -t 0 •o �, Q <br /> Applicant's Email: 41,410 Cf 054 In r> ►0 6 n'1 R <br /> **If staff has a question about this application,y�u will be contacted via email. Make sure your email address is K i <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and R :; <br /> @BurnettCountyWI.gov h 7 -0( z-z-(lb t 5 -t 3• 5 / Y--2 7 -O L 701' c °o .-- <br /> Legal Description of Property:101r cQ(i n U7 ' 12-z y(3 •-I . 13'-5 15`�� -hz o'°Z C7 qb <br /> tr1 of z z '!V ._I s 7 �� j �s Z7a Cc' L?T `� -- v ■ <br /> Section#: �'-.513 Town#: ;241" ICN Range#: I S W Town of:� (IC o --i a <br /> 0 <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 04 -- <br /> o <br /> G � <br /> Tax ID#(1-5 digit number;found on tax statement): i LI 5 , 7 y 55, 71540 4. c <br /> o <br /> • <br /> Provide Rental Information e. <br /> �© 11) Q., <br /> License Year Applied For: 20 2 Amount of Renters Applied For: <br /> Local Contact's Name: 1401Erl f rr- 1,J- -E:I`S N .11‘..L11(A.L_E F RR c y ref . g•� '� �r 40 5c1%30 <br /> Local Contact's Address: 631 I Sod h qeil IRA,' 1 v il <br /> 1 i a � 161- 11'7 State Zip <br /> Local Contact's Telephone Number: 5 ') - 3 g 7 Z <br /> ii) N_ <br /> Most Recent Burnett County License Number: STR- State License Number: NW OR-tiM 3J(l® I k <br /> Li.) s d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY c <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: g —L <br /> .Li CerIs4, t& ir-ec 113► 1zo2 a y <br /> • 1e-4tuA- lw ckt ru. -\o b.(.., pos-lead. Vtu Y .kvkt mccArN tm rarl Ce. caY z <br /> xl <br /> Ste, I-e,••4r c <br /> C 1 DI, Li(.!t-1'1c.r n) f.,e,T,l,l I(k.rV4241'FS <br /> H v) <br /> ' o�O. j a cgiver-h s�zymArt-i- tw-f- -b -exl-e.eA. 2 f k- P"'" 8 Ck#: 3t <br /> SJIN-L i-2-4 m <br /> 1/Z7)20z3 4,T Fi <br /> a r,-- <br /> Datet <br /> Date of staff site visit: Initials of site visit staff: il I ( c % <br /> (� <br /> r c °° = 0 <br /> LICENSE APPROVED BY : A ti tk► —_ DATE -5- FA ' <br /> a � ; p rcn <br /> LAND SERVICES OFFICIAL c%� 0/iq /2o13 <br /> < o c r� lJ IoJ IJ <br /> Pagelof3 vw� w <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2022 .I 2 U�ll <br /> rr <br /> rr <br />