Laserfiche WebLink
SHORT-TERM RENTAL LICENSE APPLICATION - Burnett County, WI r r <br /> a � n <br /> Applicant Complete All Sections Below This Line N. <br /> o � <br /> ❑ Original License Fee=$300 Renewal License Fee(Annually)_$150 7 a <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: l 20_qt_�N Vl/► � � <br /> Property Site Address: D5 tS J"T1 6-1/l.1QJM Ivl, $tat o N <br /> � ` cn <br /> Applicant's Telephone Number: 1 ' I � 15 W7 j l2, o <br /> Applicant's Email: (IrCI CA U� <br /> **If staff has a question about this application,you will ife contacted via email. Make sure your email address is x 0 <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov , <br /> _ rrff�� 1 � ���� pp �� , <br /> Legal Description of Property: �� n`�[l/ �� �' L �I I (.�`�I`�l <br /> 0 <br /> Section#: G- Town#:��N Range#:_� W Town of: �_� ; <br /> *Attach additional page if needed for lengthy description OR attach <br /> ��a((copy of the deed OR attach tax system property page.* � � .- <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> raj d of 4,u Provide Rental Information � Q <br /> License Year Applied For: ��/ [��^ Amount of Renters Applied For: N <br /> Local Contact's Name: l 01 t ��' v��► `� <br /> b � <br /> 2�b 7 �l. hr �► C � WAS �° z <br /> Local Contact's Address: <br /> Local Contact's Telephone Number: tY ( b b OJZ L, CityLn <br /> Most Recent Burnett County License Number: STR- Z' State License Number: y' s <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 64 <br /> � o W d <br /> THIS LICENSE IS SUBJECT <br /> 2TO-�ALL CONDITIONS LISTED BELOW: <br /> L ICQ,VISC', .�pt rruS I,-2J�� UJZ�• m � � w <br /> m C sie vS 2oq k 2025. o w <br /> a,�,A a vtvt see� no+ 't -e.%cce d 10 ly-OPle, < <br /> x -ll _08, Inokc(,io� C, i (d" • C <br /> ,] Fee Rec:iaa ro <br /> `'1ew d vtU.'dj_tLK6 � 1 e, OA*) AeQ1� U�1CllV1 Q,IITYui'��PJ � Ck#: '5U9-7 <br /> cUbr bLu l�-I-2U2S, S•e e I e-�tt " �� LiCe�,�na� rec��'tvevntn • <br /> ZZ 22 rram�.,, p <br /> Date of staff site visit:�'J"'b)-1J Initials of site visit staff: L-f 3 I j ; <br /> n _r IJ � <br /> 2 C/)0 <br /> LICENSE APPROVED BY DATE: ?-_ -2Z6- <br /> LAND SERVICES OFFICIAL CD° n w <br /> 00 <br /> -00 = 1 D <br /> w� <br /> Page 1 of 3 3Ln <br /> CD <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br />