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SHORT-TERM RENTAL LICENSE APPLICATION - Burnett County. WI r <br /> cn a <br /> r, <br /> cr <br /> 1...Applicant Complete All Sections Below This Line . n <br /> Original License Fee= $300 Renewal License Fee (Annually) = $150 �' <br /> Ps et L Y C ° <br /> Property Owner's Name: Y M!� g <br /> CD Cr <br /> Property Owner's Mailing Address: ZZb Ali-_ S fig PC S Mgt/ f S `/G& R <br /> (0 �� City State Zip y <br /> Property Site Address: S. C./PS f TT Cal of SPOc Nt. 121 in) o 'ides <br /> Applicant's Telephone Number: °IS 1-Z W--6g G r- `,"'�. <br /> Applicant's Email: a S 1'►tC i j'vtu-✓i ot r4 6 7qnet".,( e c'4-7o <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> rri <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and ' 0 <br /> @BurnettCountyWl.gov .fcoric�c� i' 2, <br /> : 10 <br /> Legal Description of Property: P�JC-i I A c r ("¢i¢- 5.'v'y A/c, 2CC l/�i_ " P9 - ZIz p <br /> et‘ ©�c N� i Z l E�� P <br /> Section#: 17> Town#: S 1N Range#: w Town o : U S v.. N <br /> a <br /> a <br /> *Attach additional page if needed for lengthy description OR attach a copy oldie deed OR attach tax system property page.* so <br /> Tax ID#(1-5 digit number: found on tax statement): S F. 2 o i <br /> o A <br /> Provide Rental Information , <br /> License Year Applied For: 26 2 3 Amount of Renters Applied For: 0 <br /> w <br /> Local Contact's Name: /►'I H-R V- A le.L Al ry g• g O. <br /> Local Contact's Address: 1 Li S I I '} 5 r- A ivt r r- �, l 5 ye e, I N o <br /> Local Contact's Telephone Number: (.15 a - 3 , `3 S (,, City State Zip N <br /> Z3 "3-� ci, 0 <br /> Most Recent Burnett CountyLicense Number: STR- 7 Z L Z ►ti G�- L 1<SS (.4 <br /> State License Number:N — a,, <br /> ,W x_ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 1 v <br /> K <br /> THIS LICENSE IS SU JECT TO ALL CONDITIONS LISTED BELOW: FSi R ns-e a ri r-eS 1 I31 207 5 -° <br /> ...0 o <br /> ix«P ,t and ad,v ex+isk-n1e.n+ no-k -k) e)(-c e-ed la papPlt z <br /> ken mod'46 r p 1 (CI -b be up -1-ed. 1,,;4. c.�,�.r�.er�,+ c <br /> Dc u.► 4.j l;Le.nSe r n6-e r b-j (,,It 12oag 7) <br /> c <br /> (i.; <br /> cn <br /> FDllow cu-t L'as-45)” eep,i r fS > Fee <br /> v Ck#: <br /> c, <br /> m <br /> x <br /> �r- l J <br /> Date of staff site visit: 2l?-2-/ y Initials of site visit staff:ek`� �_ <br /> •'m co M <br /> LICENSE APPROVED BY :c; DATE: Z/23/zDzq <br /> LAND SERVICES OFFICIAL 'm <br /> D o r o <br /> m S N <br /> Page l of 3 v ,z 2 <br /> Burnett County, WI Short-Term Rental License Application-Rev 12/2022 <br /> z M JJ <br /> T <br /> m <br />