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Slims aT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI c r t* <br /> Applicant Complete All Sections Below This Line a ri or. <br /> cr <br /> CD <br /> y <br /> Original License Fee= $300 Renewal License Fee (Annually) =$150 a <br /> y�C o g <br /> Property Owner's Name: 1 1► G-U1( FA-miL4 Ltz- <br /> Property Owner's Mailing Address: i. 341 SNE C zi17)0 I AI ' 361 y <br /> Cr) <br /> L City State Zip -- <br /> `t <br /> Property Site Address:2 14-I s 1)iti v o-N{�(i�'1 UJ I WC3z o N <br /> Applicant's Telephone Number: Padl U GI l !l{l 2z. = 3 ro r <br /> fi, <br /> Applicant's Email: m Pa rn Zlf L G et() G o 6 1 l-c Yv-lCD <br /> lal <br /> **If staff has a question abou this application,you will be contad via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 1 g <br /> Legal Description of Property:)Jrr I Csiti 5b V L Zk P 24 tied doll(l'>e `f71D,41 n✓z.6-r- � ° <br /> t7 4( <br /> Section#: 2- le Town#: LI 1 N Range#: l5 W Town of: 00 t SS N a' <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* E.w •- <br /> Tax ID#(1-5 digit number;found on tax statement): 3 7 i_ o cn <br /> n N <br /> a 4 l <br /> Provide Rental Information <br /> 7O <br /> License Year Applied For: 20 Ali Amount of Renters Applied For: t 0 N E. <br /> Local Contact's Name: .)1FNE IV?"U u 1 p,r- fD <br /> Local Contact's Address: >6 i Co b ekt)ti'Tki 6 H ( bit J t le y � £��.�O �, o C- <br /> City State Zip v <br /> Local Contact's Telephone Number: �1 IG—2-7-1-1 -,a 50 0, 2 <br /> Most Recent Burnett County License Number: STR- State License Number:M)QJV D4-'(M M O <br /> iAREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY A 5 <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 0 ,.� o <br /> d Li(enS,e. .exores ' I3l12025 in ,c cn <br /> gOccikeanc\-1 a aid a�ver+;�+ n,�+ �x«�d l� � z N <br /> () e-eakU gviA -f° PDT n2tL( - rnw n +rarlce :1 - _ iv <br /> CI by /tJ2D2 . �R-e 144-e r (L) 5) Li Q i r1� n_ :,r e 1'1'lJ?�t +S y Ck#:Fee :DUO— <br /> t� � k#: �3 ._2_ <br /> ti <br /> g <br /> l J <br /> Date of staff site visit: {1 S/2OZq Initials of site visit staff-4-- 61 L a 1, Ern <br /> LICENSE APPROVED BY DATE: / 312oZ ! <.CD <br /> 3 <br /> m .-1: inn <br /> LAND SERVICES OFFICIAL o c r = <br /> Page l of 3 0 Inn <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2023 J <br />