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SHOkT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> r~ <br /> r <br /> N A <br /> Applicant Complete All Sections Below This Line S <br /> O y <br /> ❑ Original License Fee= $300 ❑ Renewal License Fee (Annually)_$150 a <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: <br /> 1V\V1 <br /> e_C�l..� G k � �j City (Mate �' �j 1 — � <br /> Property Site Address: - o <br /> it A <br /> Applicant's Telephone Number: (p Z -_Z y 2 - W 4 2 1 c r <br /> 4 Vj co 0CA 9 e. 11 ' e- �z onc11 � , c� vn G <br /> Applicant's Email: , <br /> **If staff has a question about this application,you will be contacted via email. YAake sure your email address is x e <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov Q w <br /> rcd vJ PUL +b qo er yi tt L-o+�q3 r <br /> Legal Description of Property: y -,1 -�" <br /> �L d <br /> co-r;,,.,# I '7 town#:�l-N Range#�W Town of �C•1 Ci,L-5 /1 <br /> *Attach additional page{f needed_for lengthy description OR attach a copy q/the deed OR attach tar system properhv page.* � <br /> Tax ID#(1-5 digit number;found on tax statement): V© � ( �p N <br /> Provide Rental Information <br /> License Year Applied For: �'"� Amount of Renters Applied For: <br /> Local Contact's Name: <br /> Sc EGG 1 F' tty r� <br /> Local Contact's Address: V,-)LA Co U V7+ Fd F Sp�-1 nc)o V oo L c <br /> City tate Zip <br /> Local Contact's Telephone Number: (0 I y ~p�C) tA_) A-TCP-0112101 � <br /> Most Recent Burnett County License Number: STR- a`�-��fl State License Number: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY d "� <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: .� o <br /> LICfJA .��cp�r s � v�-2o2S. a O 0 <br /> j o �� <br /> 3J Qca--A nt?Q.� YUZUn tyA- t oee, d.001r^ + 1r�vl(zU Jwlder1lYlE$ Fee:LC - <br /> `1 > Ck#: U <br /> be LgdcutU U,*h W(-rw-�/nfw Couu4� LiCe,09_ 4�--j 54ttte L tcev>se, <br /> yk,Lvv%joey fi vpd air, LOLu.I Uv�t r e, ?hare. nu.M101-►-s V_)� <br /> Date of staff site visit: 2�2� Initials of site visit staff: L fi K" <br /> 2 n� <br /> LICENSE APPROVED BY DATE: <br /> C CC <br /> LAND SERVICES OFFICIAL < 7-1 �7 <br /> CD LI l!LI <br /> 0 O w <br /> Page 1 of 3 -0 � o <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 a) <br /> CD <br />