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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WIa r r <br /> _ cr <br /> r A. <br /> Applicant Complete All Sections Below This Line a p <br /> 0 c A <br /> Original License Fee = $300 Renewal License Fee (Annually) = $150 .- a a <br /> �r / / d C <br /> Property Owner's Name: e° 2 f 6'CL�l/e. i f i i e V eD <br /> Cr <br /> o/u ps & $ / .� <br /> Property Owner's Mailing Address: 2 a 3 6 / �^' )S in <br /> �f n y <br /> Property Site Address: /73 0 ,C5e/-/cowl /C�J4,4 j City j Sr e,�Z � 0 <br /> /� �} Y o W <br /> Applicant's Telephone Number: /� 2 0.2 / �7 00 r I <br /> *pplicant's Email: ,5 e �� r, /�/�C' C�/f?C 5 ll e't m <br /> If staff has a question about this application,you will be contacted via email. Make sure your email address is a o <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and -. <br /> @BurnettCountyWI.gov r c/�, ? / S •°• <br /> Legal Description of Property. Get 2 (`gym V/J // 3 g I- d <br /> CD <br /> Section#: v l Town#: 3. N Range#: I W Town of: e, 4 fb// /7-e � Iv <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* OQ _ <br /> Tax ID#(1-5 digit number;found on tax statement): / . 2 g• e <br /> n <br /> Provide <br /> Rental InformationLicense Year Applied For: 0? V Amount of Renters Applied For: 6morr <br /> Local Contact's Name: /dui / /'? � 06 <br /> Local Contact's Address: PD 1"Cd x L/-7/ )2/. !r/-i (�� / �� `'O/ o <br /> J City State Zip g n <br /> Local Contact's Telephone Number: <br /> 7o3- -2 c-q? _ 933 <br /> N <br /> Pa <br /> �a <br /> Most Recent Burnett County License Number: STR- State License Number: Neva— CtY6/v i Z Al <br /> _ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: y 83 <br /> •-.0 <br /> 0Li(.ul-e-- -e)cri(ts 1/31 Zoll N' <br /> N <br /> ok <br /> z <br /> Occ-ufailui Ma 04V -i' u-r1+ (Tt h n oL L e.ci In Fe r It per SA-K-2► -2 E <br /> f)itn,41 usk, unytti- be coArkd oak u) ' <br /> Pr ib vy - be- fe.r m or a t t A by I I [ZD1L{ o <br /> m Fee Rec: <br /> �2�t .id -tneS -�o be �oS d �+5i� - tt NYla i►� -e-lt nce d o Ck#: 12 <br /> by 31 tiny. S et lk- ti, 1-.1 & ,► viS ri <br /> ®k!kW allL/Ce42Sc 1 y Ike art l,�e�n 711S �Ir,�, <br /> Date of staff site visit: 12/2 p l2C'L3 Initials of site visit staff: 1 T Q. a u a L <br /> `° W m a <br /> z n <br /> LICENSE APPROVED BY G� �2 ,z� DATE: /2/22 Z.oZ m a r Inn <br /> LAND SERVICES OFFICIAL 1 < w C Q <br /> Page 1 of 3 0 g cis �l <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2022 F M Lam----- <br /> m <br /> p. <br /> m <br />