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v) r <br /> o CO A <br /> SHORT-TERM RENTAL LICENSE APPLICATION -Burnett County,WI eD <br /> Apl#t00-44 " 144001:406W:'t a 2 <br /> ps a a <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 `, "— g <br /> C,1 CA <br /> Property Owner's Name: Lip t c (-3 p�jj gs <br /> ty1cU,lt Q.o'go�31 eq "` H <br /> Property Owner's M ag Address ] U.tKl,&1 . 1 , — 9 . oE �?.± <br /> pw..bat , q ��, / r , r W vi <br /> Property Site Address: 773 1 5 ° <br /> P riY (-leaf IAA- z�2 `1� j . n <br /> Applicant's Telephone Number is-q a O - tri <br /> V 1 <br /> x o <br /> Applicant's Email:`-1 r \txixtArt E,Ct9Q464,,D ;,1.tern. <br /> • s p <br /> Legal Description of Property:\*tp 3 0 wor c)e-L% (tya,s localztairupitinanyjakloft5 !_ 2 ,3 <br /> Section#: ej Town#: 4C) N Range#: 15 W Town of ._\t1/4.4 , . t4 <br /> t <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ot <br /> Tax ID#(1-5 digit number,found on tax statement): to 2,4 9 g 40,14 <br /> `�"` <br /> o <br /> Provide Rental Information y <br /> License Year Applied For: :pb a3 Amount of Renters Applied For. (` <br /> b <br /> n <br /> Local Contact's Name:t;.lit, %4 t rg 5 b 0. i► <br /> tIyai `.9.1 .0 .3w Avi... 5 z3 z <br /> Local Contact's Address03(WO Loq o M AAAA Lk-. - V i tk) a.. 1 54 _ ►` <br /> City State Zip <br /> Local Contact's Telephone Number Oa-wit) 1 j'9.40.--jig <br /> Most Recent Burnett County License Number: STIR State License Number:A) ft!N.-e,m31-tV& <br /> AREA.BELOW"` !ND S RV10ES AFF *6 _' i °a a €t r,. r_14 i i,i <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ,-3 ( N <br /> D�.i(�2,tl�- Pi reS 131 `2A25 C1 -- <br /> DOcuAfanui ad adver-lise vn-n+" no4- -Fo - lice si L{ peqpLc... z - <br /> p <br /> rtjicuo cull Lica/5 inj eerVit:4 re/n/1/.114"S .-x (A <br /> N. <br /> I <br /> in <br /> Fee Rec• <br /> z Ck#:(o <br /> v <br /> t <br /> Ma <br /> Date of staff site visit: '2/1 1/2o2* Initials of site visit sta <br /> LICENSE APPROVED BY �f t8eia/ DATE: 121211 ZDL3 g CDW11 <br /> s3 mc7 0 <br /> LAND SERVICES OFFICIAL <br /> o <br /> Page 1 of 3 i <br /> c� [nFII <br /> Rnrnptt County_ WI Short-Term Rental License Application-Rev 12/2021 <br />