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. • SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI C r r <br /> a CD f) <br /> Applicant Complete All Sections Below This Line y p <br /> F <br /> Original License Fee= $30) Renewal License Fee(Annually)=$150 aa <br /> d <br /> Property Owner's Name: alr�tt,IC,L� eo 1„„.,, ctl . a <br /> Property Owner's Mailing Address: (i2)I 21-12l Imo/ nit :s 01° <br /> City State Zip w ".7 <br /> Property Site Address: G2551 6,r44 1.- . , DA.rubt - w I 5+50 c <br /> Applicant's Telephone Number: (251-lig 5. 53 I f o <br /> ff r <br /> Applicant's Email: a5 k1J k b IA)assd4 C 1 ma2 I. C om a <br /> **If staff has a question about this application,you will be c ntacted via email. Make sure your email address is r o <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 2 g <br /> V Y <br /> / <br /> Legal Description of Property: j ft ac.re S !U I1 6)A ., <br /> S ' <br /> 0 <br /> Li Section#: 41 Town#: I N Range#: Ile W Town of: S U);LS <br /> b` <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o <br /> J w <br /> Tax ID#(1-5 digit number;found on tax statement): 221 Q 'j d c o <br /> S. 4. U S <br /> Provide Rental Information <br /> 0 <br /> p <br /> PD <br /> PLicense Year Applied For: 202_9- Amount of Renters Applied For: ' <br /> Local Contact's Name: gr i 0.1 1 aiaiNtiakir 0 0. li <br /> Local Contact's Address: z <br /> 0 <br /> State Zip (V <br /> Local Contact's Telephone Number: -4" ' S 3 3 fl' I2 '9 j-D 11(p Z ? (N <br /> y N <br /> Most Recent Burnett County License Number: STR- State License Number: N 1A)OR-C NCL.M� ° v' <br /> z NG <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY G -L o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < ' o <br /> ' Liceinse Lh reS 1 Ji (zoz5 m <br /> y <br /> z U any old ad V�e,+ +i s.e,rl - r 4o .ex t k.td IA pe to t e o z f <br /> -6 <br /> s lidl Se u,�r 1 (iii /zo21 CA <br /> P Iz <br /> - `^ <br /> .`m1 e04 i c , 1'� fu fi . r� 4��ic2 near 4 tQ main ? d <br /> Fee Rec: as <br /> Ck#: ( ` <br /> dc�r h� t 12o2y z <br /> m <br /> r <br /> m <br /> Date of staff site visit: I (25/2/l Initials of site visit staff f .. <br /> LICENSE APPROVED BYItau DATE: 2{ 31 q a <br /> LAND SERVICES OFFICIAL 1, 3 D <br /> R. � <br /> co <br /> Page 1 of 3 a IV <br /> CD C:4 <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2023 � <br /> a EMI <br />