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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r <br /> Applicant Complete All Sections Below This Line y y <br /> 9 Original License Fee=$300 [3Renewal License Fee (Annually)_ $150 � � ii 01 <br /> d � <br /> Property Owner's Name:A/il ie "L"�1C! , Z ft <br /> Property Owner's Mailing Address: <br /> g S 5Y <br /> City State Zip <br /> Property Site Address: �2 r � e �5�C�S y i o Z <br /> ` i r� q•j / <br /> Applicant's Telephone Number: G "l9'Z 5 / L I r <br /> Applicant's Email://Y/f^��5 ,���s�� (iUP1G��Z�►-�i��/l' G'� <br /> **If staff has a question about this applicatiod,you wt be contacted via email. Make sure your email address is rn o <br /> legible and your email provider will accept emails from the following address:@BumettCountyWI.gov <br /> Legal Description of Property: <br /> d <br /> Section#: ��j Town#: Li(7 N Range#:_ L t- W Town of: ' d I� CD <br /> C t' �. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax systens property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 11663 d y c <br /> Provide Rental Information <br /> 0 <br /> License Year Applied For: C)25 Amount of Renters Applied For: P' <br /> („ ro L <br /> Local Contact's Name: IQ I <br /> Local Contact's Address: rj �e' �l1�b P�c� �/Z 3�6�� ? 3 <br /> City State Zip <br /> Local Contact's Telephone Number: <br /> Most Recent Burnett County License Number:_STR- State License Number: 0, <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> Lieense1 -eves 1-31-2oZ6. <br /> m <br /> y <br /> > O O <br /> ° z W <br /> z <br /> O �.ev��a..l G�de.��►�S -b be, �os1-ed ou.-�-Sid2� Yb.a.r YVI.a..u� �2.�n-l�av�ce. <br /> ckbo�-1a� 7'l l Z0 2L0 bee Le4_r Ul bf- LL�e As(Mj- ►-e�,u,�r s m <br /> v C <br /> r Fee Rec: � <br /> yCk#: lD/,!j <br /> m <br /> m <br /> Date of staff site visit: /— ," `� Initials of site visit staff: r16 t L.S --'�=- <br /> LICENSE APPROVED BY �� �"U�'� DATE: CO co M <br /> < 3 <br /> LAND SERVICES OFFICIAL <br /> m <br /> p o o c� <br /> Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br /> m <br />