Laserfiche WebLink
SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> Applicant Complete All Sections Below This Line <br /> IM Original License Fee=$300 ❑ Renewal License Fee(Annually) = $150 <br /> d � <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: <br /> \ City State Zip <br /> Property Site Address: �.`1 �i U M'i htt t, �- t �G^C�y�c` 1"j 5 cl 3 o <br /> N <br /> q VI <br /> Applicant's Telephone Number: L U - 5 I r <br /> Applicant's Email: 1\ A 17 `\ 'D iA co V <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is C <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov , <br /> Legal Description of Property: 1--(34 Y y la f t l , UV-- G ) S <br /> d <br /> Section#: Town#: j _N Range#: L W Town of. _Su)1.SS <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> GQ U, <br /> Tax ID#(1-5 digit number;found on tax statement): ?a 4 U 7- g o <br /> � rn <br /> � C <br /> Provide Rental Information ° <br /> License Year Applied For: Amount of Renters Applied For: <br /> Local Contact's Name: C�L ` �210 <br /> b <br /> Local Contact's Address: �tSf51 Nt rt4- J c�- C-i rcA�- Chu f b, Y� Sti 6-3U z <br /> City State Zip <br /> Local Contact's Telephone Number: 5 I - 7 C 7 - 5 L 5 x - <br /> Most Recent Burnett County License Number: STR- N r✓LAJ State License Number: A i(.-Q-U5L4I 19 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> mS � <br /> Secu,A Loj+K roc w- cIn�,tv� �� 30-2s, z <br /> 3 D C C kdv2v{-i � 'tv kceec4 t D Peop►el/9u2s+s <br /> Pay Sa-V\ - ZZ-ZI-1- ti <br /> Fee Recap,UD <br /> Ck#: 25Z 1 <br /> CL4) G l 1 bW (LU CLMAs► <br /> r re ems, <br /> Date of staff site visit: 4-20-Z U 2-S Initials of site visit staff: Fffl-- <br /> 2�-2aZs U WFC= <br /> )> <br /> LICENSE APPROVED BY DATE: <br /> LAND SERVICES OFFICIAL a o <br /> c� <br /> w C <br /> c"> <br /> Page 1 of 3 �:.'_.,_._•. <br /> Burnett County,WI Short-Term Rental License Application— Rev 11/2024 7 _ <br />