Laserfiche WebLink
SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI G - t~ <br /> cr <br /> �. <br /> CID ' A <br /> Applicant Complete All Sections Below This Line N. C <br /> 'o' v ffpp <br /> Original License Fee= $300 -) Renewal License Fee(Annually)=$150 a <br /> Property Owner's Name: ,r7 of" ,,,./ c.769 v/ Gtc . '1 4. r o f <br /> Property Owner's Mailing Address: Hi 5-D / 9c c1 r/1 L /=`5 -/c ,"l`'v S0(3 `�k) n <br /> /3 e t'1e./ & s City State I Zip ? R"It 7d <br /> PropertySite Address: / AprC d/'�rr' LJ`7� � ? R N <br /> Applicant's Telephone Number: �/ 7 t' ( i9 71/ o �(�` <br /> r^ Q. <br /> Applicant's Email: j21ii 11 t U +7-4-I e_h'l de re)Z.r L 1VI/1 B <br /> **If staff has a question about this applicatiorT you will be contacted via email. Make sure your email address is k o <br /> legible and your email provider will accept emails firor the following address: @BurnettCougtyWI.gov 9. g <br /> Legal Description of Property:Z-a T 1 b2 ci`-/eCv t/ t.,'7c, / / 3 <br /> S ° v_ <br /> Section#: -; � Town#: 4/0 N Range#a W Town of: -L±. "' 1 ^ <br /> *Attach additional page if needed for lengthy description OR attach a copy ofof the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): 3 e,�3 7 d n o I'- <br /> Provide Rental Information ^ < <br /> li <br /> License Year Applied For: 2d v? Amount of Renters Applied For: f hi <br /> Local Contact's Name: 7L1,47 `; 0 .L-i cc., ./ftif�!�l I Sr .17 0 <br /> Local Contact's Address: / %4 �j7 ; ,Q, 6 (�, S�a'' .,' LA12:- 3 f'/ z <br /> V/(i ' CityState Zip <br /> Local Contact's Telephone Number707-7 77 ^63 / ?7l 3477 _ ; <br /> Most Recent Burnett County License Number: STR- *Pi— State License Number:1�IJ-GZU .DC m "' N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o c O v <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < .3 -3 <br /> eLiCeAR )COl reS 1131 l22s y o <br /> a 0 <br /> PDcLura C y u ad c ,�-fiS vl0-1- 4-0 eu c d z z <br /> P-U se- 2.1 . 3oi .;, i-__ <br /> >1?kil-1-0 5U,IMA l'k-t/3 40 VC- ?"4-Ci OU.4. 101,1 aCiV -HASL ITVIA6 0 - <br /> Fee Rec. <br /> -e.A+1o,.n.ULQICOr• S2. I pCi-l-- tl- �[, 0 -1�.. LibaiSi '� PQtt,L;rej t44 m Ck#: <br /> �� be tbm.FIZ--itch 611 j202'-1 m J <br /> r ((M <br /> Date of staff site visit: ' O iDZ l Initials of site visit staff:"er a D <br /> 2 r/202i' . z <br /> LICENSE APPROVED BY � DATE: `_„ <br /> LAND SERVICES OFFICIAL o <br /> 0 o0 <br /> N cc <br /> a.,< N <br /> cp <br /> Ifni <br /> Page 1 of 3 <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2023 <br />