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SHORT-TERM RENTAL LICENSE APPLICATION - Burnett County. WI r r <br /> cr <br /> a CD n. <br /> Applicant Complete All Sections Below This Line 7<• S <br /> o' "' <br /> CD <br /> Original License Fee= $300 Renewal License Fee (Annually) = $150 g. <br /> d <br /> Property Owner's Name: ,.�111(�� ('f\ +- )4it4iU') L IRn i eL1� 0 <br /> Ei �s <br /> Property Owner's Mailing Address: 3ci-s (041 rn44 Sr- Alillfl clr S MA) JJ`•//7 <br /> City State Zip <br /> Property Site Address: ri.-011, Li pse-+ A•C.r.,,SS P.ci SpL>v4e4' IA)1 Sy gt / o 11,4 <br /> w <br /> Applicant's Telephone Number: 2 t% 'Lcq 3y otv s <br /> Applicant's Email: GL hii✓C.t,J m.r i e t"k ;NI a t 1. Cc;-nl <br /> CD <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is i <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and <br /> @,BurnettCountyWI.gov a' <br /> !:10 <br /> Legal Description of Property: PC.L L LSr i V ( P 212 r t h Croce t"t 3) ° <br /> N r. <br /> Section#: 1 Town#: 39 N Range#: 14 W Town of: JQ Lis lli g <br /> *Attach additional page i needed or lengthy description OR attach a copyofthe deed OR attach taxsystem property page.** cm <br /> PS f f g Y P P hP S P. ( N3 <br /> Tax ID#(1-5 digit number;found on tax statement): / qlA , g`t• o r, <br /> Provide Rental Information , <br /> License Year Applied For: -1Lb ZLl Amount of Renters Applied For: (0 I <br /> Local Contact's Name: -'JA.vE! Aunt. g <br /> 0° <br /> IV o i <br /> Local Contact's Address: N LA 11 I 4 nG t)1 Lit s *ov aeir l/ 1 SLi 4O I 11 n, to <br /> _ L ,J City State Zip N <br /> Local Contact's Telephone Number: 11 r — -I)- 3 W ci 3 -..z <br /> oa .� <br /> Most Recent Burnett County License Number: STR- NJ I A State License Number: N 1tOe It,-f-j I-1 P Z ) -- -.I a' <br /> W x <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ° <br /> (De,nse. 'Up IIsiIzo25 N <br /> r� <br /> ��0 C( anc'q ctal aCtIR S-e- 1, n+ not 4t -ex cu.Q.d le 1zofLefaim#?249-7 <br /> IRe n_i_aa 5t xakt1 ots -b It fosteri old--side nkst-i --- rnu:t n tt'I-I nc e- <br /> clew la.( 2b5frD2z.1 Sez 164te (L) 6I l,i lit ins ee�w�e r✓�e/rf-S <br /> r Fee Rec:30 b <br /> °' c. -kink nk li� -�I a 1 oid r�l tct 11 d Ck#:U9 /Old1`� ' - be �ro Y S,e�,a ie�J <br /> s/zoiq <br /> C. Poltow 0,U, U si nq �-cc itre tvt -i -�S <br /> Date of staff site visit: I 20/ZOZ3 Initials of site visit staff: /� l <br /> I o n <br /> Q1 � �. <br /> LICENSE APPROVED BY C �/1A.n ��DATE: i2/z7 ZD23 <br /> LAND SERVICES OFFICIAL n m CID g (I( <br /> � 0n�1 <br /> O 'a S u 'C <br /> Page 1 of 3 1 ,‹ ,;? <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2022 a `�`' <br /> C <br />