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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r r <br /> � A <br /> _ Applicant Complete All Sections Below This Line 5 p <br /> �/ y <br /> 0 Original License Fee=$300 6/Renewal License Fee(Annually)_$150 <br /> m v � <br /> Property Owner's Name: 14 � A <br /> Property Owner's Mailing Address: � <br /> Ci State Zip <br /> Property Site Address: / o N <br /> Applicant's Telephone Number:... �3; —� 1 {1 J3 ";�I"/ ' �, o r <br /> Applicant's Email: t 1� I Y1 t' 2 7 a <br /> **If staff has a ques' n about this application,you wilLoe contacted via email. Make sure your email address is h <br /> legible and your email provider�llnaccept pema-i}ls.from the following address:@BumettCou�nftyWI.gov <br /> Legal Description of Property: ��S i.Lr� J-S�ati� Ad 4' <br /> Section#:� Town#: m <br /> N Range#:��W Town of: = l31 <br /> � <br /> *Attach additional page if needed,for lengthy description OR attach a copy of the deed OR attach tax system property page.* a .- <br /> Tax ID#(1-5 digit number;found on tax statement): 7� d N <br /> 5. o, <br /> Provide Rental Information s < <br /> License Year Applied For: � � Amount of Renters Applied For: Do �• <br /> Local Contact's Name: �� h Y14 L -o <br /> Local Contact's Address: � k 1�i OV/1 tO 7 d e) z <br /> 0 <br /> 7 _ City State Zip <br /> Local Contact's Telephone Number: <br /> Most Recent Burnett County License Number: STR- q-j r1/ <br /> State License Number: 4 Mo—0 7 8 `" <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY N '� <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: H o <br /> s0 ot,ikp 0 <br /> P 's 0 <br /> O o <br /> '361satj� <br /> fC�4� Fee R <br /> .Q,cC�►�c �� , <br /> IS�-n,Ft L3 3-3-ZS <br /> 2� �` <br /> Date of staff site visit:<_�I;�7 2,/=7 Initials of site visit staff: Ll-� <br /> r � <br /> C <br /> LICENSE APPROVED BY �� / DATE: J � J <br /> Cn <br /> LAND SERVICES OFFICIAL `D 3 <br /> m ` C <br /> Page 1 of 3 �� n� o <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 3 <br /> C <br /> COU0 hp CmAt'k"/ 3, ee, paie, ��(� <br />