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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r ri <br /> n ... <br /> Applicant Complete All Sections Below This Line 5• CD 0 <br /> A <br /> C <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 E. a <br /> a <br /> Property Owner's Name: Joseph Kvidera g. <br /> Property Owner's Mailing Address: 5957 Pike Lake Rd, Webster, WI 54893 <br /> City State Zip K 4 <br /> Property Site Address:3706 Half Moon Circle,Danbury,WI saes <br /> Applicant's Telephone Number:651-605-5017 a <br /> `1' . al <br /> Applicant's Email:joe.kvidera@gmail.com 00 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is b 0 <br /> legible and your email provider will accept emails from the following address:@BurnettCountyW1.gov k, A <br /> Legal Description of Property:Half Moon Add to Voyager Village Lot 48 <br /> Section#:13 Town#:40 N Range#: 15 W Town of:Jackson <br /> N <br /> o � <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 1. w V <br /> Tax ID#(1-5 digit number;found on tax statement):7486 o N <br /> � o <br /> g. 7- <br /> Provide Rental Information -'d <br /> a. <br /> License Year Applied For:2024 Amount of Renters Applied Fo O ,r t <br /> Local Contact's Name: Joe Kvidera <br /> Local Contact's Address: 5957 Pike Lake Rd, Webster, WI 54893 0 <br /> p 651-605-5017 City State Zip <br /> Local Contact's Telephone Number: W <br /> U' I <br /> Most Recent Burnett County License Number: STR- 23-52 State License Number:SXIG-CS4KGH 5 - .z <br /> a — <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o (),) <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: S o <br /> �e I k I �J C` ` � 00 <br /> OLDt � sl <br /> °x z <br /> 0. O c n 0.n-d cudw+isz►n c +- np+ I vc 12 � = N <br /> 3 <br /> r r ( 1_,I.(per( &tut' � � , -�J 6 ✓0k) OD l.0 i 1� ✓E�i!to t ` a Fee Rec: I-5D <br /> Ck#: I act 0 <br /> S <br /> m <br /> Date of staff site visit:3/II /2X2Lf Initials of site visit staff:—k / .4" G L. <br /> s�iA g il /2071-/ [rlLICENSE APPROVED BY DATE: Q <br /> LAND SERVICES OFFICIAL mc°c B <br /> o i <br /> m <br /> D o - <br /> Page 1 of 3 cD S C <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2023 3`.< <br /> m sin <br /> L� .J <br />