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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI E I r <br /> Applicant Complete All Sections Below This Line d E <br /> co <br /> Original License Fee= $300 Renewal License Fee (Annually) = $150 8. Z <br /> Property Owner's Name: 1;r I.( 41'14 6 ro I h, LJ_y <br /> 0 Cr <br /> '' 'ti R <br /> `f 151 fk V' pr. ttiu 1 i .Y' i t S`(i.) <br /> Property Owner's Mailing Address: )) gc) <br /> IS 55 �.k `-K • 6rCity Slate pa93 cProperty Site Address: '� / �!{ i'�� ' r'� �' o <br /> Applicant's Telephone Number: I I S- G-1 1 - Oii�7 0 E r O() <br /> Applicant's Email: er;c I''�� ?b, tyad <br /> i C c • (r�., a � <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is E. i <br /> legible and your email provider will accept emails from the following address: urnettCountyWI.gov P <br /> ) <br /> Legal Description of Property: CVN1 Z ib CG�v Lfl 5 �i. .r 31 1 <br /> d <br /> /V� r v <br /> Section#: ?5' Town#: �GI N Range#: 1 b W W Town of: '!C:e hc,4,1 1 r- `° <br /> s. - <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 2 <br /> Oo <br /> Tax ID#(l-5 digit number;found on tax statement): 11711 p n w <br /> N <br /> Provide Rental Information '� <br /> 1 <br /> License Year Applied For: it Amount of Renters Applied For: N <br /> Local Contact's Name: Joe. k v; 2 Y c �, i....._ <br /> b <br /> pj <br /> Local Contact's Address: S:cf 7 pik� �Fe InreLScr kv-1- 5� ” oc,L- o 4 <br /> City State Zip L <br /> Local Contact's Telephone Number: I I' - S 9 I 1 ---1 <br /> Most Recent Burnett County License Number: STR- State License Number: !1 I `P - O S 3$`i� i`1' N <br /> a 'N W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 6 i(-) e <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: _ <br /> 01/1(fAt -t\L r'eS l 1. t I2o25 j <br /> CD O cox?an GI an6 v (H eA► " no-k -I-o e. -t ec ci 1-1 12e ot'Lt per <br /> S kc' -2L1-In <br /> DI I al a S 4 i t pos ea oc + v - e.. YVIC1,I n tihiranU I <br /> G4AOf b ' /!6/w2-' • Sek ie-{'4e-r (1) D'S - 4 Liar/Da, Op tifen' Fee Rec: y_ <br /> sa Ck# �[ <br /> ( J1IoJ Git! Liceigin, et ju iie M g <br /> Date of staff site visit: 1I'3120Z41 Initials of site visit staff:cYT <br /> LICENSE APPROVED BY <br /> . DATE: -T/ZJ!-*% E. ` t1 U ll <br /> LAND SERVICES OFFICIAL Z.m r <br /> m .^. -.. Ifni' <br /> Uo c.0 <br /> Page 1 of 3 fl M <br /> Burnett County, WI Short-Term Rental License Application— Rev 12/2023 <br /> nn <br />