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SHORT-TERM RENTAL LICENSE APPLICATION - Burnett County, WI C r r <br /> Cr CD <br /> ... <br /> Applicant Complete All Sections Below This Line 8 D <br /> C Original License Fee = S300 Renewal License Fee (Annually) _ $150 a <br /> Property Owner's Name: CD <br /> Property Owner's Mailing Address: .Z9V d � <br /> ity State Zi <br /> Property Site Address:26Q�6 W AeA7oe-1 6ate2- ��, �5 ail/1 .r09.3 o p N <br /> Applicant's Telephone Number: (5�'9)2 YZ-ig*K6 <br /> _ r <br /> Applicant's Email:__AacS-oUy Se-A OL6 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is k C <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov , <br /> Legal Description of Property: 3 br- house ch -/flG�1�hH-�P�i7� LOLL <br /> d <br /> Section#: 3 Town#:3 9 N Range#: W Town of: �4SK <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Shy s <br /> Tax ID#(1-5 digit number; found on tax statement): 3 <br /> Provide Rental Information <br /> N <br /> License Year Applied For: 20Z S Amount of Renters Applied For: (Q � � �• <br /> Local Contact's Name: �Q Y &'cesro 41 <br /> Local Contact's Address: 2572-7 .16hg olq lgao' Ael rkef3 z <br /> W��"" 2 City State Zip ,� U <br /> Local Contact's Telephone Number: Z — % -S 3 x <br /> Most Recent Burnett County License Number: ST�Z-2`�"G'7 tate License Numb ^� �a ° `� N <br /> tN <br /> a Q % x <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 6 W tj <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -, <br /> © Lt C2vISe, �r2S -31- 2o2(a. LA <br /> nu.wkb2r 0-� OCCurpakitS ?cv- �PrN-23r22� ►�� �0- -202S, _ <br /> CJ 1 1 acard n ea,,- d � <br /> �IAV�f2,1/� LAC e.V1 .11\U�►M�(dQl� �0� Fee Rec: <br /> b <br /> �U-►�1 Ck#: (0(a <br /> x <br /> m <br /> 'F)l 16 l,,) Cl.l I t t r_e 15t V,5 r-e�w re r►..Q v,kS. --�j ��] <br /> Date of staff site visit: ��11J U a� Initials of site visit staff: LZ+ KG <br /> a <br /> J7�d'ZOZS m (l(11(ll <br /> LICENSE APPROVED BY DATE: <br /> LAND SERVICES OFFICIAL v o r <br /> c� <br /> 90 o <br /> 3Q cr <br /> Page 1 of 3 m <br /> Burnett County, WI Short-Term Rental License Application- Rev 11/2024 r(�--------J <br />