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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r <br /> a <br /> A <br /> Applicant Complete All Sections Below This Line < g y <br /> °o c co <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 a. <br /> !X E <br /> Property Owner's Name: v` h Ni a r h ® V LY A - Ni b ri-to '' ewe <br /> Property Owner's Mailing Address: I J w Pod y LAIL> �-t'1 4k Lr"""' tlif ilq 55004 4 <br /> �j City tate `p_ �, p <br /> Property Site Address: 2,..3 to 410 (iI Y��-I l�/t u.- T,7 A ss S ZiW , < N <br /> Applicant's Telephone Number: (i 11 • Z12 • �5(4� �� 1 <br /> Applicant's Email: Ob V h In 4 a !1 b /Mai ' y / <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is 0 <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov R <br /> I l D F Lb (v S r to I. t E fir ,4 Scar Am. 'I�'► vo g c.— <br /> Legal Description of Property: `` d <br /> Section#: 13 Town#: 4D if N Range#: l5 W Town of: V fi�li,�U` Y►( {� N 9 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* �. w <br /> Tax ID#(1-5 digit number;found on tax statement): el 401 a E N 1 <br /> a. c i <br /> Provide Rental Information <br /> License Year Applied For: P„b 24 Amount of Renters Applied For: iJ _ F. <br /> Local Contact's Name: 6 `'C-V O bb- l'A b Z, <br /> t f �Q - r k D a� l,l, w °° <br /> Local Contact's Address: 2Si5 T f i,eG� / I Cv b t o <br /> Local Contact's Telephone Number: 7-t v — 't`C D ` t{ '2- City Stake 31) ' <br /> Most Recent Burnett County License Number: STR- State License Number:ry(C f- 0 54 0 53' <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o W v <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: c ' o <br /> 0 L1.(enV aria S 1 Ji <br /> /zoz o <br /> - Oc u- afic_i and ak,l'- ' -n fD+ -'o -eY-Leta 4 PP ' 7 �' <br /> Sa11 i}ter'y if(eCo50 — <br /> t <br /> C '"ki Nial ti) rf J,�� �J D near -Act Yna-i0 -Orafice r! _ <br /> Fee Rec: 360CP <br /> dwibi ',Dig <br /> ��' m <br /> m <br /> Date of staff site visit:5/1'!/Z r Initials of site visit staff: ("Li-n'` <br /> Fril <br /> cD <br /> LICENSE APPROVED BY 0,/ ./ , DATE:P/23/20/1/ T M <br /> LAND SERVICES OFFICIAL m ` <br /> 0o <br /> Page 1 of 3 0 o <br /> Burnett County,WI Short-Term Rental License Application— Rev 12/2023 <br /> J <br />