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t. ', �. <br /> SHORT-TERM RENTAL LICENSE APPLICATION —Burnett County, WI o y eo <br /> m <br /> Applicant Complete All Sections Below This Line ,- S. 2 <br /> os o B <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 , v c <br /> Property Owner's Name: C (P y ft <br /> eB <br /> t1-Ntki1i •Q.t�,�ic SlO 51-tr,WL.5t1(M yA <br /> Property Owner's llieg Address , C ," - ° <br /> Property Site Address: ? 773 1 C1ectc Sft4l. 1:0 L\ShY yA�r C7r. 'Ac ' pQ <br /> Z <br /> Applicant's Telephone Number: ,1' -q LA O — CI <br /> trI <br /> 0 0 <br /> Applicant's Email:\t MCvo-sra S�tiMQ y <br /> `1 --, h1.;,,� ,O1'►"1. c' <br /> r 6 <br /> o 0 <br /> Legal Description of Pro e \D (0. d <br /> P P rh'� ,�Ztswr sky �(�+5 lac��}��s�+�}-bra i jZ�t <br /> Section#:, j Town#: 40 N Range#: 13 W Town of: Jc+,c. . ,t . o <br /> w <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* oo <br /> g 2 <br /> Tax ID#(1-5 digit number;found on tax statement): ( 1 a <br /> R c <br /> Provide Rental Information U\ � <br /> License Year Applied For. Oba3 Amount of Renters Applied For 1'4 I. <br /> Local Contact's Name:1„0 6 At n b I. \ip. <br /> Oweeq.P.I ' L'x'.axle, 10 va- i.,rIwl-, 5Ltt'13 94115 <br /> o <br /> Local Contact's Address( y>je> L 2 40 Ml~1\AJIA 1...k. 1'l . k k ff. <br /> City State Zip ` <br /> Local Contact's Telephone Number(r ,oQ:,,) `, 1 -'14 ----33cfi <br /> [ 1:4..,Most Recent Burnett CountyLicense Number. STR- State License Number.. <br /> a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: g N <br /> ()LicLnS.E .- pi res ' 151 `2026 o c.a <br /> r2 ocuAfeau,L1ma adver4i s.e r As-f" n o-1- +0 -e kceerl Li p ,... z ..-- <br /> ,03 kituiu ca Lice,45ink ee,N , 0\ <br /> N <br /> Fee Recy-'7 <br /> 0 <br /> Date of staff site visit: 12/1 f/2ol3 Initials of site visit staff: T <br /> , <br /> y , <br /> 6- <br /> LICENSE APPROVED BY / 4/01-, DATE: 12 2-Li ZDZ.3 to <br /> o m 0 <br /> LAND SERVICES OFFICIAL n <br /> c) - <br /> 0 <br /> O <br /> Page 1of3 nfl <br /> u.tru ff f~nnnty_ WI Short-Term Rental License Application—Rev 12/2021 �:77 )) <br />