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SdOKT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r r <br /> -. <br /> cr <br /> Applicant Complete All Sections Below This Line y. CD = <br /> Original License Fee= $300 Renewal License Fee(Annually)=$150 < . <br /> d <br /> Property Owner's Name: A00C,. ?_:-O s F ° <br /> cr <br /> Property Owner's Mailing Address: (4 Si 9 15ka iSCi f`l Ate. MI vy a? ,.3 MO 351/ ' e. <br /> City State Zip <br /> Property Site Address: 24 �3 Oily n l i S�ti� ) no <br /> NW <br /> Applicant's Telephone Number: Le )Z -S -11 I_b <br /> o <br /> Applicant's Email: a vl00 . 'i''aS et r r t,•l .(r.)"� <br /> **If staff has a question about this application,yo,6i will be contacted via email. Make sure your email address is x o <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and <br /> @BuntettCountyWl.gov Le) r I CS At\ V 14 P G It L�M L- 1�J5 14,i} 4[it <br /> r o. <br /> � c <br /> Legal Description of Property: COO V I I c IC`6 IN t,DV Lin" c <br /> Section#:_11 Town#: il 0N Range#: 15 W Town of:444211 ! K Sr�l = W <br /> 5 <br /> Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property?we.* clq — <br /> G cn o <br /> fax ID#(1-5 digit number;found on tax statement): 5 Z Z a <br /> < <br /> c <br /> Provide Rental Information ry r. <br /> ^ <br /> License Year Applied For: ZoZ g Amount of Renters Applied For: U) —� <br /> � <br /> v I <br /> Local Contact's Name: SI�►a� �c 1 i S <br /> z <br /> Local Contact's Address: Z(gi 0(t)( S - t: q k + (2rL M 4tK V. <br /> S-TAS <br /> q 0 <br /> City State Zip O1 <br /> Local Contact's Telephone Number: Le ll"4 Z 5-10 LiDWG.CSZ Np� C11 <br /> Most Recent Burnett County License Number: STR- State License Number:9 5b -i s -{ 7 s'i <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY -19 <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -' i N <br /> •Liu.A15e ,,Mires ' 131 12ov-i o y N <br /> S \-}-wry Ptc rvb►+ - 366 ( _ <br /> • -46L nk- 1;CIS mus-1 bit I od-ed a c - -►,,,,,:t, 1 -i-tt Loa 4-c, h _ r <br /> P)/low ci.,UL Li(,QXI.S f ►isl e �(,1.! t� n'fs Fee Rec:�p— <br /> J Ck#: j Sill/ <br /> T <br /> Date of staff site visit: te 1221 Z� r <br /> Zr7 Initials of site visit staff. ( a, <br /> o a <br /> LICENSE APPROVED BY q DATE: //1( 20Z m 3 c c C 0 <br /> LAND SERVICES OFFICIAL ® I E <br /> - <br /> Pagelof3 VD gy . <br /> Burnett County,WI Short-Term Rental License Application— Rev 12/2022 m inn <br /> �'°' <br /> z - <br />