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w <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI t. t-� <br /> cr <br /> get CD A <br /> Applicant Complete All Sections Below This Line y n : <br /> o' N <br /> al <br /> Original License Fee= $300 Renewal License Fee(Annually)=$150 ,- a. <br /> c <br /> o B <br /> Property Owner's Name: Tnm Bourn CD Cr <br /> fo <br /> 1.1 <br /> Property Owner's Mailing Address: 28595 Half Mann Court Danbury,WI 54030 Danbury 54830 CA <br /> City State Zip ,- <br /> Property Site Address: 2R5g5 Half Moon nnurt I•lanhury,WI 54830 < ISO <br /> r t' <br /> Applicant's Telephone Number: 715-57g-297R ° <br /> g <br /> Applicant's Email: tmmedustthng cnm <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is ril b 0 <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov ' <br /> R <br /> g. <br /> Legal Description of Property: Farral In 07-m2-2-40 15-13-5 15-270-027000 15-270-020000 15-270 020000 S —` <br /> Section#: 1 Town#: X LLO N Range#: 41 15 W Town of: jarkann <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* r. w <br /> Tax ID#(1-5 digit number;found on tax statement): 7454,7455,745A 3 E N K <br /> n C <br /> Provide Rental Information514 <br /> License Year Applied For: 2n23 Amount of Renters Applied For: a ' <br /> ro <br /> Local Contact's Name: Terry Rollin b i <br /> Local Contact's Address: l2S1 1 S &lkiS..4 TC rJ.\ o <br /> City ►' State Zip C/l <br /> Local Contact's Telephone Number: 7R3-R87-3972 x <br /> Most Recent Burnett County License Number: STR-23-10 State License Number: Nwnr-nm3j4d CI <br /> m lo- <br /> r. 1 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o CA d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < y o <br /> DLiCtrt-S - expires I &l 12025 y v <br /> D CLLV c y n and aelVti+h� me- z,n+ n o4- -}o e x(e ed $ pe,,pk <br /> 0 <br /> : lc <br /> SA-s1-21- 2LP <br /> n ,Ti, <br /> t. <br /> 3 �llU) at Li ceASVA1 i sRILA:►(CrYurrk-S d - /5v <br /> Fee Re"• <br /> Ck#: 2$ <br /> x <br /> m <br /> m <br /> Date of staff site visit:_ Wi(iV Initials of site visit staff: U.+wr - ' <br /> m 1nn� <br /> 4 ,Q,t', e ((/2L7 j 202qu 1!a �_ <br /> LICENSE APPROVED BY DATE: coc° <br /> Z,3 <br /> LAND SERVICES OFFICIAL m �nn' <br /> c- U u it <br /> C O <br /> 5. N <br /> Page 1of3 g <br /> Burnett County,WI Short-Term Rental License Application— Rev 12/2023 a) tin <br />