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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> � r <br /> y <br /> Applicant Complete All Sections Below This Line E2. p <br /> °c c <br /> K.Original License Fee= $300 0 Renewal License Fee (Annually)_ $150 a <br /> Property Owner's Name: 11{.-e iVx,a h 3 �P f ►ate-� l'r �.Z :; <br /> Property Owner's Mailing Address: 0.f Ce <br /> / /^ City State Zip <br /> Property Site Address: a4, <br /> Applicant's Telephone Number: Z/O f r. <br /> Applicant's Email 1 C V-C W.,10 L-,, Cv(A-t z©I v 4c c I c cc <br /> **If staff has a ques ' n about this application,you wii4 be contacted via email. Make sure your email address is O <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov <br /> Legal Description of Property:L t 1 1p L' ' o r v, I �, I CI bac3 1 y d <br /> Section#: /L) Town#:_Y� N Range 4:�_�'v Town of: 9 v S ' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed ORrattach tax system property page.* w <br /> Tax ID#(1-5 digit number;found on tax statement): 15��l '� o a'! <br /> / c <br /> N <br /> l7 C <br /> �Q 4 Provide Rental Information ° <br /> License Year Applied For: C r Amount of Renters Applied For: <br /> � Iy <br /> Local Contact's Name: A1,y,4VeVkt iZ P v4C, t' C L C <br /> I- '� C i UQ <br /> Local Contact's Address: �Q L+ f`i ��v L� ✓ �1 l( 4: K t ��� �c�� — o <br /> City State Zip 4 <br /> Local Contact's Telephone Number: (P S/ - 7,1 -4 o <br /> Most Recent Burnett County License Number: STR- N �� State License Number:4TL C l SO <br /> m y <br /> AREA BELOW'PHIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> O <br /> LiCe, �tj rep 1 -31- 202�, <br /> 2U 2 � 2d25� o <br /> �1 z ._ <br /> �ev mfi z <br /> j 0 <br /> ���� <br /> Fee Rec: �� <br /> CLII.t d r , 9U,I&JtrCS Lxq 1r16fY d aid b Ck#: I S23 <br /> Lc C.tAk atk wl b — log 511 2 u 7-5, <br /> F I-K4 0 '6t,j d i►V.S �U Card t-o 6e.pb§ed o U ioLe) ► UL► wAat tj t.vvfra,n <br /> �Sor s/11 ao a5, See Lt-H{ L o f LIC"Si rj rttw re-w�a.�-+�-s. <br /> Date of staff site wit. Initials of site visit staff: <br /> r <br /> LICENSE APPROVED BY DATE: Q <br /> �w -r! <br /> LAND SERVICES OFFICIAL <br /> m <br /> (no w <br /> Page 1 of 3 � > <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 2i <br /> CD <br /> �� <br />