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• <br /> • <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r <br /> n <br /> Applicant Complete All Sections Below This Line a eD <br /> a• w <br /> Original License Fee=$300 Renewal License Fee(Annually)=$150 a <br /> Property Owner's Name: �J o hn P p bs t f-t, 1 t 1 (5"TR =r Jc 5-1-mc�-E'S L t_G) C� <br /> Property Owner's Mailing Address: I CO nk sf- iJ Ur + 1-1-2-1 ?re s c9€t luT b` 0 a-I y <br /> City State Zip NN ,1 <br /> Property Site Address: a-S`(9 4- I�u �3 Co w, L 2 C✓c I i. ) 1 r‘ �i1 w?-. 5-1 -4 3 D 0 <br /> <<_ <br /> .P. <br /> Applicant's Telephone Number: (o(a -710-1-7 21S r <br /> rp <br /> Applicant's Email: 'on d F t 1 @ k-W. CDm r 0 <br /> **If staff has a ques o about this application,you will be contacted via email. Make sure your email address is o 0 <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov M <br /> o• <br /> Legal Description of Property: (R- cl raJ ° d C— <br /> Section#: 01 Town#: LID N Range#: i y W Town of:S[ )4+ CD <br /> C <br /> _D <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): ' H'A 114 13 Cdt 2 o <br /> nr <br /> Provide Rental Information <br /> w <br /> License Year Applied For: ..)-0may-- Amount of Renters Applied For: q pti , rk,4 <br /> Local Contact's Name: Pu&AJ Pcx_r. si- <br /> b <br /> ao <br /> Local Contact's Address: (.€,aSS ic--t.c 2-,o f er as 1>0e-(:,Sf-zr LLD 5'1-$43 0 <br /> City State Zip IS <br /> Local Contact's Telephone Number: (al a-5 S ( -3 $. ,6 xNI <br /> Most Recent Burnett County License Number: STR- 4 f A• State License Number:p-TLP-OS'-1-1't9 I W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < a <br /> 1Lictn - 1 I3t /iO25 P g <br /> 2 D and d ver�%�f Hof -ex�e�� il � o z <br /> Sti-N 422D31 <br /> � 1 d-e. lea✓ � N1cuh rti � <br /> C) �e 1 ict4' - o b pos--kd ou s <br /> D�,�,,� by it 112o2.L-I. lt� r (I) rt LI l e.l'Is 11", Pep;r� 4% Fee Rec3 <br /> U� ''"' .Q. l I J ro Ck#: 11l9 <br /> z <br /> ter' I <br /> RI�RNA) UM N cuaS 1el Fett i►rwt m <br /> Date of staff site visit: 9/!7/Z-02`/ Initials of site visit staff 1 r <br /> �n a <br /> qCr) inl <br /> LICENSE APPROVED BY : DATE: / GU/ZOZ� m c' 0 <br /> LAND SERVICES OFFICIAL m a Ind <br /> U <br /> 0 o J o <br /> CD e cD <br /> Page 1 of 3 g <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2023 � Ira <br />