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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WICD <br /> r r <br /> a <br /> ... <br /> Applicant Complete All Sections Below This Line �• <br /> O y <br /> ❑ Original License Fee=$300 11 Renewal License Fee(Annually) = S1 50 a <br /> Property Owner's Name: 0 ice` DO 1,-614 A� CD <br /> rD <br /> p g 6 f 9 &���►b�' f�a 17�lUr I�7 jV,0q �Property Owner's Mailing Address: t <br /> t City State Zip <br /> Property Site Address: y-5 7� ��,� + /RAJ 1.fo o <br /> Applicant's Telephone Number: <br /> Applicant's Email: ,Q�,F}�y J14SU%y Q' /QIJ ,C'1�F^� <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: @BumettCountyWI.gov w �, <br /> Legal Description of Property: far c�f^'1 -'PIVR8 V'7 P A?W3 <br /> Section#: _Town#: W N N Range W Town of: X o N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> // ao <br /> Tax ID#(1-5 digit number;found on tax statement): p? b N <br /> 016 Provide Rental Information <br /> License Year Applied For: Amount of Renters Applied For: Ct <br /> `� N � <br /> Local Contact's Name: F t 1� �� <br /> Local Contact's Address: f� �� RD, y ?Pky 5-Vj- 9 �+ o <br /> �� ���� � City State Zip -� <br /> Local Contact's Telephone Number: —7�� S �j i <br /> Most Recent Burnett County License Number: STR- 'r 9 State License Number: <br /> y ! w <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: m <br /> Q LlC.e-�nSQ �1re�S t- 3 L-20 2(0, y <br /> N <br /> 10 2L1 +U 25 > <br /> z z <br /> r* iT Jhc•l.2ed l ID puple, pe,r <br /> m <br /> �N� 2o—t9c.v• � _ <br /> (lu,trl'Q,Y1 f Fee Rec:���t/S <br /> O 61-0-rd ,Ref l wlde.�l►il&S '� �Od aid US� 5, Ck#:�457 t- <br /> L�Gelns�e t►n�o�n oYn t Co. COv� �� 301 M z9s8 <br /> rM <br /> Date of staff site visit: -22'25 Initials of site visit staff: 1-5 + k G r- ��- <br /> 1 -2y-Z5 Q <br /> LICENSE APPROVED BY DATE: m r z <br /> < 3 <br /> LAND SERVICES OFFICIAL <br /> m <br /> 52. <br /> DCD <br /> o w o <br /> Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 CD J�j <br />