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SNORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> c r <br /> a � n <br /> Applicant Complete All Sections Below This Line 4 CDy <br /> °o c A <br /> ❑ Original License Fee=$300 I1 Renewal License Fee (Annually =$150 a z <br /> e <br /> Property Owner's Name: � �2 ( -P^ CD A <br /> Property Owner's Mailing Address: <br /> r City State Zip o <br /> Property Site Address: Z� (..Y(� i,Jn J� l 't V�' G(L>��S bv- 3 , C j �'+O Q N <br /> Applicant's Telephone Number: S ( <br /> Applicant's Email: ID }�>At > PIL>-K-'Q, �, pw{ (00 �. C.�M CD <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is 0 <br /> legible and your email provider will accept emails from the following address:@BurnettCounty`WI.gov ' <br /> Legal Description of Property: WLT LOT 4 C S M V 0H 6,04 Lb i S 44 <br /> `C�� <br /> o d <br /> Section Town#: :37 N Range#:__j_J ._W Town of. _1_N>& U-'2- 3� <br /> 'Attach additional page if needed for lengthy description.OP,attach a copy,of the deed OP attach tax system property page.* o Q <br /> � w <br /> Tax ID#(1-5 digit number;found on tax statement): 2 3 t 1 S d o <br /> 5. a <br /> Provide Rental Information ° <br /> License Year Applied For: �Z S Amount of Renters Applied For: ? <br /> Local Contact's Name: CN N D U(Lm.;�,r3 " <br /> pp IQ <br /> Local Contact's Address: Z 1 L4 q 1n.1,I J vJ Lb <br /> City State Zip <br /> Local Contact's Telephone Number: I Li 0 41 �.r�. I,.� <br /> 2y- 59 -a <br /> Most Recent Burnett County License Number: STR-q�3 6'i State License Number: 6 `� O <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY _ o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> O LicW,Sp— moires 1- <br /> ZO P10-WA + Re -1 C�u.(Adwes ADbe- updated Wi4h Corre(A- 154alt 0 z <br /> C1Cev\Se., number + Currev>{ Couv�t I.t�e)ALL .be►- by 9-15-U2r <br /> m � <br /> O 0 CCu � A- 0.dv�v�i5e �►-4s tom- �o .,2ac.Cecc� 7 pe sa 3y93p. _ C� <br /> d � <br /> Fee Rec: <br /> b Ck#: �7l <br /> Fo I\0l�) Clk1z Cevl� <br /> Date of staff site visit: S 2$—2J� Initials of site visit staff: <br /> LICENSE APPROVED BY Ti1� � �WtY.t DATE: "Z9 2o�S� CD m <br /> m a 4 <br /> LAND SERVICES OFFICIAL m ``` <br /> Cyr <br /> D o oc r� <br /> Page 1 of 3 �Z p <br /> .. <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 S <br /> CD <br />