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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> r <br /> ,. a n <br /> Applicant Complete All Sections Below This Line NCDy <br /> Original License Fee = $300 Renewal License Fee (Annually) _ $150 a <br /> d <br /> Property Owner's Name: Iselin Donaldson <br /> Property Owner's Mailing Address: 4228 12TH AVE S Minneapolis MN 55407 y <br /> City State Zip c N <br /> Property site Address: 3372 D H E I N DR Webster WI 54893 <br /> a <br /> Applicant's p li ' Telephone Number: 507-649-1332 <br /> Applicant's Email: iselln.a.donaldson@gmail.Com <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and <br /> @BurnettCountyWI.gov LOT 3 CS M V 7 P 190 (IN G OV LOT 1 & B N G P RT <br /> Legal Description of Property: LOT 1 � <br /> d <br /> Section#:_ 19 Town#: 40_ N Range#:.14 _W Town of: JACKSON <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* n <br /> Tax ID#(1-5 digit number;found on tax statement): 18223 <br /> Provide Rental Information con <br /> License Year Applied For: ' 2� ZoZs Amount of Renters Applied For: <br /> CD <br /> Local Contact's Name: Mark Brunner <br /> z <br /> Local Contact's Address: 1011 Burgs Park Dr Shell Lake WI 54871 <br /> City State Zip • <br /> Local Contact's Telephone Number: 651 -347-3568 <br /> Most Recent Burnett County License Number: STR-14Q NZIJ State License Number:•la' /TCP-DS <br /> _D <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY _ <br /> 10 <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> LL Cep Y-P�'��S 1-31- ZoZ�• ..c c� N <br /> rjo+ to -A4Qee_A 4 pe�- z o W <br /> - <br /> 6Z�ean,-la,t <br /> c�uo�- 10 ` Lp -3D-20 2(p • SP-e— l t,�►' Lad LL G2��h9 Ir�Qt lt►'2W Fee Rec: <br /> J p Ck#:� <br /> CJ�L w 000l Sk)e- � n�edS a Lop (Lash Use P";f) <br /> 100 S�• � btj '7-1- 2-02-57, r <br /> Date of staff site visit: 06120Z� In•tials of site visit staff,4(T <br /> 0 0. <br /> c C <br /> LICENSE APPROVED BY DATE: 5-5-Zo25 <W r— <br /> LAND SERVICES OFFICIAL < 00 `� c <br /> Page 1 of 3 <br /> ti r <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2022 CD <br />