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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r r <br /> ... <br /> Applicant Complete All Sections Below This Line 5.. m <br /> y el <br /> Original License Fee= $300 Renewal License Fee (Annually)=$150 a c <br /> C9 /12�r�so' /eho/ V GEC • ° = <br /> Property Owner's Name: � a <br /> 2970 a2oc. J . w.esf aeshmu�y`M^/mac'- ` o q <br /> Property Owner's Mailing Address: n • <br /> 1 /,�C,ity, tate Z�ig "� "i <br /> Property Site Address:269?6' 4 , SO'T ‘atee �� aivi .L S ?# ' o <br /> < CF N <br /> Applicant's Telephone Number: G�y2-6 r�'6 <br /> o . <br /> Applicant's Email: film m as is on her oil ti,I @ c r17fl-ZG . COM <br /> co <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is ril 0 <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov <br /> Legal Description of Property: ripaeC2/al /and /t /ew lh coup.r e (..?T-� o <br /> o Fs <br /> Section#: 3 Town#: 3 9 N Range#: /4 W Town of: 4-1.5"-ie' N " ' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* • <br /> o5-. • <br /> Tax ID#(1-5 digit number;found on tax statement): 3S� S' u. n o <br /> N <br /> n. C <br /> Provide Rental Information o <br /> License Year Applied For: 202[� -leT) <br /> cA <br /> c 7 Amount of Renters Applied For: 4% <br /> ,�/ yle-e e cesoh _ ' <br /> Local Contact's Name: "a � � <br /> 25-722? A /a 4of G�ieiriei- Gv1 s 3 0 z <br /> Local Contact's Address: o <br /> p ( 2o) /,������Q City State Zip L N <br /> Local Contact's Telephone Number: y J -3 �'' <br /> in. R <br /> Most Recent Burnett County License Number: STR- State License Number:fi7P'4525-0 (7 o <br /> c .1 <br /> x <br /> g <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < H o <br /> - JA <br /> LICLMV?j t4 \) ,\J w7- s rsi- <br /> 0 cusk., \‘`4 w* --o to Q o4 c Pet. SP\►J-2 -z2 o z r <br /> — \ t.D AAV 90YA O -Y0 be, p ms' u t Q t%k .), 034.6, '. , <br /> se,a \ <br /> crl <br /> ' Fee R c: <br /> a) <br /> Ck#: �, <br /> m <br /> A <br /> R7 <br /> -�1::::::)..." <br /> sp <br /> cG Date of staff site visit: 0 `5 )1_oV'k Initials of site visit staff: L n TIFL <br /> A <br /> � rT — 0 <br /> LICENSE APPROVED BY : el/MA //f 1� p <br /> DATE:0`1q`Z° < 3 _ <br /> 2 `D o in Fli <br /> LAND SERVICES OFFICIAL o ^) o <br /> v iv <br /> Page 1 of 3 i Fla <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2023 _ _J <br />