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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County. WI r� r <br /> cr <br /> Applicant Complete All Sections Below This Line 00 <br /> Original License Fee=$300 Renewal License Fee (Annually)=$150 <br /> Property Owner's Name: I 1 V/1 ,(i1 i/ g cr <br /> clew eo <br /> Property Owner's Mailing Address: (+ 1 10�J�(n 5E � 10 V ill I V/ 65 3 t 9 cn <br /> tate Property Site Address: �� -CY�CASure �StAhU+ VP�IV� 00y F�ANIC � Z� w� 30 5' Pe <br /> Applicant's Telephone Number:119 - 2' n ` 1(b o i 00 <br /> Applicant's Email: 111. 95g TT/6)9 rr.o,( ' (A!)Y I v <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is o <br /> legible and your email provider will accept emails from the following address:@BurnettCountyWl.gov x <br /> Legal Description of Property:1Y 6 Arc iCtoh�l Act WQVI t v Voya,yeY Vi iigr{ k-l/S 614.55 s' ' <br /> / d , <br /> Section#: 12 Town#: l 6 N Range#: R i 5 W Town of: 0k fn �^, <br /> *Attach additional page i needed or lengthy descnption OR attach a copyofthe deed OR attach taxsystem property page.** n —L <br /> P S r f % Y P P P t3 P S =• (� <br /> ao <br /> Tax ID#(1-5 digit number;found on tax statement): 6 i 03 0 � o <br /> 3. s tg <br /> Provide Rental Information <br /> License Year Applied For: Z 02y Amount of Renters Applied For: 6 <br /> r <br /> 1) z,,, <br /> Local Contact's Name:-.3-06\ WX 1 <br /> CD <br /> Local Contact's Address: N U(5g Li 1-4-1--y.V at k.ey ea tc w k s ti ss) o <br /> l City State Zip <br /> Local Contact's Telephone Number:1lQ 3- $lv - 0124 3 A H <br /> Most Recent Burnett County License Number: STR- State License Number:ATC P- 06 35Z7 P, g <br /> .„ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY d N xd <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < y o <br /> 04 <br /> (D1Lic tact tx,7ifeS \I31I 1 w o y o <br /> CD Ocu ark (xdver sio-,AL4-17F v`D4 4,, ..exceed 6 -)PLk- PLX o z <br /> S 3SSD1 z x) <br /> CUi Ciali yes --ici 6 vo Yitcl otkl S i Je 14w -HAe nitLi ri <br /> - <br /> QY1 L 0,vtu, (21 1 <br /> ,Od✓ D .1 10115 I ljp_1• It{ ttile.,' (L' ri Li cuts in) I ti.,ti t4 ifiti Fee Rec: 3 5 <br /> b Ck#: "3> <br /> (94 ttio cJu L.iu.ril i r1 eel t ti re m-�-S <br /> C� m <br /> Date of staff site visit: 5 3 I 29. Initials of site visit staff: £ L'rl6T r- U <br /> tv <br /> q / �n n <br /> LICENSE APPROVED BY DATE: r ! !�' " "" <br /> LAND SERVICES OFFICIAL 0' " �' <br /> n ti <br /> "0 v <br /> c r <br /> Page 1 of 3 a� n? <br /> Burnett County,WI Short-Term Rental License Application-Rev 12/2023 <br />