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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> � r <br /> A <br /> Applicant Complete All Sections Below This Line <br /> K A <br /> 0 Original License Fee= $300 ((Renewal License Fee (Annually)_ $150 p g <br /> Property Owner's Name: 4suSCs n Cr <br /> � A <br /> �s <br /> Property Owner's Mailing Address: A ��•� �Jl! \ <br /> city State Zip <br /> Property Site Address: 3t-7(59 i CA-LA VA 4A � <br /> w <br /> Applicant's Telephone Number:(c Sj -44D - I <br /> Applicant's Email: C �U l V' ���y-I e !i1'm 1 , C—n rn n <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: nJBurnettCountyWLgov w <br /> 'C,,CaC,,-,. o. <br /> Legal Description of Property: + C7 CSM r 9 q I �101 Z7 Pjg-1 c-S boc I <br /> Section#: Town#:__3 OL_N Range W Town of: R ks (s W NE) N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* B <br /> Tax ID#(1-5 digit number,found on tax statement): <br /> Provide Rental Information <br /> License Year Applied For: P1y0)5 Amount of Renters Applied For: -J <br /> Local Contact's Name: 'SLkf 41 1�V01i �S <br /> Local Contact's Address: C�� S n P r� � i T 5 L4 Eo I N z <br /> City State Zip <br /> Local Contact's Telephone Number: C.05 I -q L4 Q �lo3 q J <br /> Most Recent Burnett County License Number: STR- HS State License Number:,. 1�_TC' ©OC?QO <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 6 d <br /> TMS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: y o <br /> 9 �- -� <br /> (;CCu p( CLv�rl Q d verb CCcXI Y16I' eP 0 z <br /> m <br /> Fee Rec: 1z O(t <br /> Ck#: a� <br /> z <br /> Date of staff site visit: Initials of site visit staff: <br /> � ,+ 1 <br /> G mc� � � U <br /> LICENSE APPROVED BY DATE: "J <br /> . CD <br /> LAND SERVICES OFFICIAL Cn c <br /> Page 1 of 3 0 <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br />