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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> r, <br /> Applicant Complete All Sections Below This Line <br /> ❑ Original License Fee=$300 eRenewal License Fee (Annually)_$150 r <br /> 0 <br /> Property Owner's Name: M oG tt,-rp F F19MIZ <br /> z <br /> Property Owner's Mailing Address: N fi V -%U14 <br /> City State Zip a <br /> Property Site Address: )�2 5?3 9 L,1R F,S AA) V F z>,1 N8UA y w3 '920 0 <br /> Applicant's Telephone Number: j110!J/�5 y- <br /> Applicant's Email: zq <br /> **If staff has a question out this application,you will a contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BurnettCoun�W o� yr,� ' <br /> R e eo2At' <br /> r <br /> Legal Description of Property: LOT r Ex CS/)g VOL 1170S0,3 ;,, /aLgt6 0 <br /> Section#: 6 Town#: Range#: / W Town of. SCcJ/S J` <br /> N <br /> *Attach additiona/page iJ needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br /> Tax 1D#(1-5 digit number;found on tax statement):^ Z 71 ° CA o <br /> n CA N <br /> O C' <br /> Provide Rental Information ° <br /> License Year Applied For: a.Og�, Amount of Renters Applied For: <br /> Local Contact's Name: 7'/91ve- <br /> Local Contact's Address: 30/6 8 COce.-vT y AQ&h H, n&,vauR y , W_z yg3lJ o <br /> City' 9tate Zip <br /> Local Contact's Telephone Number: .. 19 - a, 9' 7� ATCf- O f 100 = J <br /> Most Recent Burnett County License Number: STR- State License Number: <br /> a N x� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o S o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: �, o <br /> Occvn d- FVd +- ceerf( � pe,r sa� 35g71 z z -? <br /> 3/30 2Z2, �c '-e' rn �s <br /> Ly d 1CW1 Fee Rec. <br /> G2 Y►,& V1 u Wl(021'' 1 ?i 1��. Ck#: l D/,,l <br /> m <br /> a <br /> m <br /> Date of staff site visit: —Z�-—25 Initials of site visit staff: LIJ l <br /> a � 6 <br /> LICENSE APPROVED BY DATE: CD <br /> LAND SERVICES OFFICIAL o IJ u LI <br /> CD <br /> Page 1 of 3CD <br /> c <br /> Burnett County, WI Short-Term Rental License Application—Rev 11/2024 <br />