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a <br /> DEPARTMENT OF AGRICULTURE, <br /> TRADE AND CONSUMER PROTECTION <br /> License, Permit or Registration <br /> The person,firm,or corporation shown below has complied with the Wisconsin statutes and is authorized to engage in the activity indicated. <br /> ACTIVITY I EXPIRATION DATE I.D. NUMBER <br /> I Tourist Rooming House(LTR) 130-Jun-2024 I NWOR-CLFQEH <br /> LICENSEE MAILING;ADDRESS NCT TRANSFERABLE BUSINESS/ESTABLISHMENT ADDRESS <br /> ' <br /> EDMUND JOHNSON BIG SAND LAKE ESCAPE <br /> 114 HERITAGE BLVD 4792 STATE ROAD 70 <br /> HUDSON WI 54016 WEBSTER WI 54893 <br /> I <br /> _____ <br /> All Permits Juno it is the responsibility of the licensee to ma1e sure all applicable fees are <br /> r1n Permits expire. on 30th; �� w ui�. vlry 7 .,.r.r.,.......,.., <br /> received by the department before July 1st or a late payment fee will be assessed. <br /> If you rin not renPive a renewal form prior to June 30th from your licensing authority, v_ ou <br /> should send in your payment for renewing your permit to the following address: <br /> WDATCP-LICENSE RENEWAL <br /> DRAWER 296 <br /> MILWAUKEE, WI 53293-0296 <br /> (608)224-4720 <br /> inciucae the name of your facility and the ID number. <br /> F-fry-1 71 <br />