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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r- r <br /> .. <br /> a r, ri <br /> Applicant Complete All Sections Below This Line -' CD <br /> -f• <br /> Original License Fee = $300 Renewal License Fee (Annually) 50 <br /> a C <br /> '(i �.-e�-9 u say, FD d g <br /> Property Owner's Name: R.e. 4- 1, so_ Cr <br /> pMailing awin al `1 t al 31i SA- \cc, k_4&e. kLt sque \ . <br /> Property Owner's Address: <br /> City State Zip 0 <br /> Property Site Address: Lp[log it `,C(,, Q.(1 webs- r w= S y 1-9 3 <br /> < N <br /> A <br /> Applicant's Telephone Number: 1 15-S 7 q U• Litt y i, - 1,,�a Le\a IA q I tot, 1Q.t i d o ' <br /> Applicant's Email: ` F. <br /> �1 <br /> sar-erotaon 1\\\ t5 rna�1. cCP" <br /> **If staff has a question about this pplication,you w41 be contacted via email. Make sure your email address is x O <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov rtri <br /> -. <br /> Legal Description of Property: 1(A' a C1111V \p Lk.a i- p \Di l ( Sr v s Also loi.5°4 g o <br /> fb <br /> Section#: )J Town#: 39 N Range#: 1 kg, W Town of: f\to tip 11 <br /> NV*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* . 4y,,_ <br /> Tax ID#(1-5 digit number; found on tax statement): \\ . o c,,n o <br /> Provide Rental Information o <br /> ( <br /> License Year Applied For: p�uff``a‘'I Amount of Renters Applied For: � — ? <br /> (— <br /> Local Contact's Name: Tl Y rus�rn "� <br /> Local Contact's Address: lU S to k o Cr\I&A-4,1 rm-f\ P.11 S(Aer- 1-u, SLI tol <br /> City State Zip N o <br /> Local Contact's Telephone Number: —I ) S s-aD 1 ora y, <br /> Most Recent Burnett CountyLicense Number:_S R- N 1- - Z'e �� d N r11 tale License Number: <br /> � 23 -O5 z H <br /> J x AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> Es <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: A —3 <br /> Ott iCt evVrres 1131 /wz' c' g <br /> m t 1J <br /> fk oa.nui acvJ cLv v- - -/- ral- -occetd 3 q,c_ <br /> o z <br /> a---Gun pityttioci av;) ,>z-i--s <br /> m �— <br /> PI a Card +0 IX (,t p6Lr,-fed wi-d-�, r-e.v�-kt e T u i�Ld i 4 e .1 (Yn&t or1 , se e < c- <br /> d <br /> I-�-W--k-r is+ L cc; 1I Gt n s k►ci I re u t it,rne-✓j . lA pa,1 b'{ 6 I l 12-07)-1. Fee Rec: <br /> Ck#: <br /> dunkhcuse lvuA. ed q, lax l D 1l8$-/ Can be reAd. I-P Rvictuiu <br /> rtn+-1 ni 114j4 2025 rert,t?,wea v-ik t nod b.e t scald.. m <br /> Date of staff site visit: r- <br /> C�� <br /> 150Z,11 Initials of site visit staff: w <br /> LICENSE APPROVED BY '41 DATE: / /2.1D2g <m �"' D 0 <br /> LAND SERVICES OFFICIAL 2 `-° Ps.31i,i,i <br /> a0 �„ IJUIJ <br /> Page 1 of 3 L!...J3 <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2023CD <br /> Cc=--D__J <br />