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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r r <br /> a g n <br /> Applicant Complete All Sections Below This Line <. n g <br /> Original License Fee= $300 Renewal License Fee(Annually) = $150 ,. g. <br /> d <br /> Property Owner's Name: (.JkSCt ;(-\ C� v &R\I LC f S v cr <br /> Property Owner's Mailing Address: Al)O C.)"\-ti R C � -'L1', W� 51-W, <br /> `` C`i State Zip <br /> Property Site Address: 3 70A3 C ga R. , Spoo-c,e c) <br /> Applicant's Telephone Number: (051 - -\y a- l LD�y r <br /> Applicant's Email: SC \D Ll {C 01 e 3 rnckk\ . Ce.yo-) i °Q <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is rri x 0 legible and your email provider will accept emails from the following address: nBurnettCountyWl.gov I. .(4) <br /> Legal Description of Property: Lot 2. oS CSM 1494 ` id 2.1 pZG}1 Ooc.4 4itt ytk <br /> ' r <br /> Section#: a Town#: 3`9 N Range#: l`-I W Town of: R k.... (Sw' NiE) e <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* F. <br /> pro' w <br /> Tax ID#(1-5 digit number,found on tax statement): 35 4 I g c \ <br /> a 3 N • <br /> lV <br /> o <br /> Provide Rental Information 1� , . <br /> License Year Applied For: a O�'-E Amount of Renters Applied For: N N. <br /> F <br /> Local Contact's Name: .-_--)ke 4- `Ry ay-) &g.n('�S ro I <br /> Local Contact's Address: Di \ 0 C—A�,1 Q� t-C , 4 ao.c, c 1 \.j J 4%c l o <br /> City State Zip N.1 <br /> i <br /> Local Contact's Telephone Number: (051 - Li 4 r) - Lo?,L -J U) <br /> 2 3- 3(o y <br /> Most Recent Burnett County License Number: STR- o-D. 15,E-- State License Number:OWV fi i-CC TCrA <br /> P a <br /> a y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 6 N LA o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: a c W <br /> 0 LkenS-e tx fi��S `3 t ZbZN - -C <br /> a✓tc 0,06/ eintu - cu n no- -e)cC Q d 2. fexpu.. <br /> 'D e ltDw call <br /> bufisiN) Getwife +S _ <br /> d Fee Rec: A <br /> Ck#: <br /> 1 <br /> l J <br /> �/ ' <br /> Date of staff site visit: 2 ZZ �Z'7 Initials of site visit staff <br /> 3111111 <br /> LICENSE APPROVED BY , DATE: //2z/2O2 0 <br /> LAND SERVICES OFFICIAL N c� o, U u►t <br /> 00 0 <br /> 48 g_ c <br /> fit=< <br /> Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2023 L` J) <br />