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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r r <br /> Applicant Complete All Sections Below This Line a f <br /> o' <br /> 0 Original License Fee = $300 ZRenewal License Fee (Annually) _ $150 <br /> Property Owner's Name: 61 ev o f4aven LLC,(e�� ° j4 � <br /> Property Owner's Mailing Address: q:-zz 1 rheswicL UV V ► lvl. a 4\9 <br /> C, Ci State Zip <br /> Property Site Address: /0 I E've q(e-en f �t 44-, J pgc., e W% 5g4o l o <br /> < N <br /> Applicant's Telephone Number: 501 (J -5471 rCD <br /> Applicant's Email: r CD <br /> **If staff has a question about Ms application,you will be contacted via email. Make sure your email address is o <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov <br /> Legal Description of Property: C �11 3521q 1, (ti E <br /> 'l d <br /> Section#: "1 Town#:_23q_N Range#: W Town of: - <br /> N <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 5. <br /> Tax ID#(1-5 digit number;found on tax statement): 616 <br /> 5. o <br /> < <br /> Provide Rental Information ° <br /> License Year Applied For: �v�J Amount of Renters Applied For: I n�3 <br /> _s> < <br /> Local Contact's Name: 1� t'qe y"t-y)c baoj l S <br /> Local Contact's Address:�`?�(� kU y�eL..q (AU'e— C fy-)e r0 v-. LA.',' I 5c/ 2.2— o <br /> City State Zip <br /> Local Contact's Telephone Number: -] 1 5- (P 51 - J 4 6q x <br /> Most Recent Burnett County License Number:_STR- OL3 State License Number: PrTC R'o 370 ° <br /> a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY y o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> (�CCv ow �l d n�- tU -e xCeec( I g �� o z � <br /> r <br /> n <br /> m <br /> O r Cm '1 I C �� Uni ed bu --� . G �re�- <br /> _nAuP S <br /> � d <br /> Fee Rec: <br /> 0W►nl?rS. P1+nv -fu.+ur2, Y,eA► Ct+S al 11 ►need to 5o 4krtt �L)P Ck#: /b,3 <br /> {'�raceSS a�a1>7. rM <br /> Date of staff site visit: �- �5 Initials of site visit staff: L-S + K16OL <br /> _..- <br /> m cD M <br /> fT'I <br /> LICENSE APPROVED BY G DATE: A'��+�GZ l <_3 O� <br /> CD m t*.� <br /> LAND SERVICES OFFICIAL `A 0 -_a <br /> 0 a r <br /> T5 <br /> A <br /> Page 1 of 3 <br /> ' i <br /> Burnett County, WI Short-Term Rental License Application—Rev 11/2024 ; <br />