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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI w r r <br /> ... <br /> Applicant Complete All Sections Below This Line y• y <br /> g 0 <br /> Original License Fee= $300 Renewal License Fee(Annually) = $150 a <br /> �p d ° <br /> Property Owner's Name: I &l1+ Pi\ tt 1 f a it °� c <br /> Co11-7 COu,,1•�-� ts L A UV,)kt W i S/ 73 <br /> Property Owner's Mailing Address: ,.t y <br /> City State Zia <br /> Property Site Address: (O'a Cl 1—J e>Lk rl e .. td (AA b 4- r /�/% yaiy3 0 ' <br /> �- N A <br /> Applicant's Telephone Number: 7/5-- S ,6, f o)_3 ° r <br /> Applicant's Email: 'f re/Vt, Yin A- re L— 1 �!4/'�O , (GAY( 6 <br /> **If staff has a question about this application,Ou will be�ontacted via email. Make sure your email address is til <br /> O <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov P' <br /> �-0Legal Description of Property: t' LI Cs V V re <br /> , 1 l o:> ( i•n otfI 5cd'(0✓ K g. —\ <br /> Section#: S 9-5 Town#: 1 tI 1 N Range#:' . t (0 W Town of: C) K,t Cfiwl. i <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): 13 0 <br /> a i <br /> N <br /> In <br /> 2. C <br /> Provide Rental Information <br /> u v e <br /> License Year Applied For: a.0�LI Amount of Renters Applied For: I 1� ___I R. <br /> w <br /> Local Contact's Name: I{9-1/1'+ 1 V tAl C(3 T, <br /> c. 0 5 nn ro <br /> 0. <br /> Local Contact's Address: Go. I L 7 LO(L , k it" W e h54-er w/ SC/g`i [4 ,1 o <br /> _ U City State Zip <br /> Local Contact's Telephone Number: . 15-.5 (D (a-I O 3-3 <br /> ci <br /> Most Recent Burnett County License Number: STR- State License Number:I\TC P " 0 36 .( w N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o c� o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < H o <br /> m ° G <br /> 0Licenn•e -ex 'S t131`ZoTs y bs p ? <br /> f <br /> Occupancy and advver se-rma - ao# -l-o -e.x-teed c( z <br /> rr <br /> 3 itow aLt Lice.t1S'►nc) Olc ire,Mt-A+Srz <br /> H Fee Rec: . +_ <br /> Ck#: <br /> x <br /> rm <br /> x <br /> rn <br /> Jl J <br /> Date of staff site visit: 11 6 1 H Inirals of site visit staff: GL Y r <br /> LICENSE APPROVED BY /72 /DATE: m g = 0 <br /> LAND SERVICES OFFICIAL ma. =-oc <br /> D o O <br /> Page l of �-'' <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2023 <br /> C JJ <br />