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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r <br /> a � � <br /> Applicant Complete All Sections Below This Line s <br /> 0 <br /> ❑ Original License Fee=$300 Renewal License Fee (Annually)_$150 a <br /> d � <br /> Property owner's Name: Gabriel and Katherine Perron Pantano a. <br /> Property Owner's Mailing Address: 1159Ruggles Street Roseville MN 55113 y <br /> City State Zip o <br /> Property Site Address: 25252 Pike Bend Road Webster WI 54893 N <br /> cn <br /> Applicant's Telephone Number: 612-270-0997 r <br /> Applicant's Email: Mperron@gmail.com <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov <br /> Legal Description of Property: Lot 1 CSM V15 P202 (Gov Lot 4) i <br /> d <br /> Section#: 25 Town#: 39 N Range#: 16 W Town of: Meenon a �+ %. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* T <br /> � w - <br /> Tax ID#(1-5 digit number;found on tax statement): 11893 d o <br /> 5. a <br /> � C <br /> Provide Rental Information ° <br /> License Year Applied For: 2025 Amount of Renters Applied For: C4 L Tl <br /> Fo <br /> x <br /> ox N <br /> Local Contact's Name: Heat <br /> ao <br /> Local Contact's Address: 301 Polk Ave. S Frederic, WI 54837 o <br /> City State Zip <br /> 715-566-4560 <br /> Local Contacts Telephone Number: x }`� <br /> � Sv <br /> Most Recent Burnett County License Number: STR- 24-49 State License Number: ATCP-011685 <br /> r Qlp <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> 2� on�� +,kL t %&v% d t,)P_A[ nrn <br /> C3) 0 COA)eaAcq arj_ OAu-p_�'Semtrd- ne�- tD kated q pti- <br /> ORar j (.�uK.�IYI� "f placa d It & vpd-11 Gt( b9 3/M12z2 0-� Fee Rec: l� <br /> n,Q t� �f GIB Q:k , �.(CR,4'I�S2. i' L' Ir"I'�Uf" SfiG�� CLN SZ Ck#:� <br /> x <br /> (nig. <br /> m <br /> Date of staff site visit: CX`5-a Las Initials of site visit staff: <br /> mm D <br /> LICENSE APPROVED BY DATE: 01 -5 Boas < = z <br /> m ` N <br /> LAND SERVICES OFFICIAL o 0 o <br /> -a = CM <br /> Page 1 of 3 <br /> 3 c.� <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 C� <br />