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SNORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI W r r <br /> A <br /> Applicant Complete All Sections Below This Line <br /> lQl Original License Fee=$300 0 Renewal License Fee(Annually)_$150 <br /> d � <br /> Property Owner's Name: <br /> ' i/2 Ln1 �c.lGc� L vt1c r�1 y <br /> Property Owner's Mailing Address: <br /> Ciitty•- w -, State Zip <br /> Property Site Address: ,�e�4LA <br /> Applicant's Telephone Number: Z �7 7 "- 7 S r, <br /> Applicant's Email: 1T <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is p 0 <br /> legible and your email provider will accept emails from the following address:@BumettCountyWI.gov , <br /> Legal Description of Property: Lerr2. C5M �tA18 f V2y P 12 (4*,qD9215) G1-1 ° <br /> d ` <br /> Section#: 5 19 Town#:_TtLL N Range#:_J2 r-, W Town of: 5 W l5S N <br /> ° N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): 2 T L{ 9) c <br /> Provide Rental Information <br /> License Year Applied For: W25 Amount of Renters Applied For: <br /> Local Contact's Name: %/M <br /> Local Contact's Address: 30/ctQ U_= isno kxr- vdrgao oz <br /> City State Zip <br /> Local Contact's Telephone Number: <br /> y <br /> Most Recent Burnett County License Number: STR- N e w _State License Number: PtTCP_0SSC�1 ° <br /> r � <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o ', <br /> Q) d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < o <br /> (D <br /> ((eoS& k <br /> C-A) <br /> aid o de rear Ynt�i� eut��ahce� G, <br /> dca� � letter " L`' I �ee�lsi Re `�' <br /> c au�,��u�CwA Ctcty �1 S ri vti S r1 c�- teed (� }ev1Oi e o <br /> Fee ec: <br /> Ck#: o2V� <br /> C �S4d V�.eds LCU/16( USt v"�'Vt��" j `7—�"Zv25, IF firer i LC S�• <br /> L's" 611 e w ct.l Q LtCe�vt sl v�� r �u,�r e Y► <br /> Date of staff site visit: Initials of site visit staff: K6 + L 2 a <br /> > a � <br /> LICENSE APPROVED BY Z�' C ,lif' DATE: m c <br /> C Cl)cri <br /> LAND SERVICES OFFICIAL mCD <br /> N <br /> 0 0 <br /> fD C A <br /> Page 1 of 3 <br /> 3 <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 � L� <br />