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v r el <br /> a CO n <br /> SHORT-TERM RENTAL LICENSE APPLICATION —Burnett County,WI N: " d <br /> fp <br /> Applicant Complete All Sections Below This Line ` E. 2 <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 S g <br /> Property Owner's Name: (1-5F:t <br /> u) <br /> Property Owner's ling Address t) yc Ld svo`i..�t \j f . • ° tit <br /> Property Site Address:? 773 i (-lea./ SY{. Pci t,� -,u c"-)9 q , r <br /> Applicant's Telephone Number01q, -°aD m <br /> o <br /> Applicant's Email:k-►ro,, -yr4 S(1t-}C3%Q c r�-,�,,1,,C rin. o. PI <br /> s <br /> Legal Description of Property:\o lb.d C j; .y.04,A 1 CP_51ti ‘ :v it r} 1u£ 1}7 i 3 - d <br /> Section#:�12j Town#: kt D N Range#: 15 W Town of: x-, < ;t,) l <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* oo <br /> `-t"Tax ID#(1-5 digit number,found on tax statement): L ?,,411 s. 3 <br /> Provide Rental Information c v\ % <br /> ba N �` <br /> License Year Applied For. Amount of Renters Applied For. t'`� ,� <br /> -o <br /> 9 i \► <br /> Local Contact's Name:t��ti I���rs�.5 ern <br /> 01UI+,Y,'•pU.e IQ �lzy.W1-+ 5L S 73 0 <br /> Local Contact's Address0AnW > 4340 3 MA\\#uk 1_ .-. t T�11 � <br /> City State Zip ` <br /> Local Contact's Telephone Number({: \ '94 --wig <br /> c„ N ,.... <br /> Most Recent Burnett County License Number. STR- State License Number.I) DR.-(LIM J+Y <br /> B <br /> cx) d <br /> AREA BELOW TIllS LINE FOR LAND SERVICES STAFF GY]MMENTSICONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> D Li cQ.nS.C- . ri res t 1st j2025 Q <br /> 12 o a adver4i sz.mt.n.+- n o-E- +0 -ac t4 Li p'eq.t - z <br /> x, §, <br /> ()kit,. a/ . Licei/5!rtj P V.6 cn <br /> in I <br /> y <br /> ' <br /> Fee:(c, <br /> to <br /> A <br /> Date of staff site visit: 12/lC1/2oZ3 Initials of site visit staff: 1�7- n ' , <br /> m <br /> r=" <br /> LICENSE APPROVED BY / [/(!�'ri1/ DATE: I 21211 Zoi o 011 <br /> rnn 0 <br /> LAND SERVICES OFFICIAL <br /> r�.w J Ifni <br /> �"l) -0- <br /> N <br /> G.tit <br /> Page 1 of 3 �_ `'-� <br /> tt f Rnrnp minty_ WI Short-Term Rental License Application—Rev 12/2021 _ <br /> _ f <br />