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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> � r <br /> Applicant Complete All Sections Below This Line S p <br /> Original License Fee= $300 KRenewal License Fee (Annually)_ $150 a <br /> Property Owner's Name: eL <br /> -To/ <br /> / l n <br /> �Property Owner's Mailing Address: / `�t� /1 �� � i� G �4f P y <br /> cl S 9'%/ �! u �a � Y"Property Site Address: C✓ S /' � � W to <br /> Applicant's Telephone Number: <br /> Applicant's Email: kh 040 <br /> **If staff has a question about this application,you will beWontacted via email. Make sure your email address is o <br /> legible and your email provider will <br /> •accept <br /> �emai�ls/from the following address:@�jBurnetttCountyWI.gov <br /> Legai Description of Property: <br /> d <br /> Section#: Town#: 40 N Range#:_(0W Town of: �CLk.12r� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* ? •- <br /> II 2 w <br /> Tax ID#(1-5 digit number;found on tax statement): I OS J d cnn c <br /> Provide Rental Information <br /> License Year Applied For: ��Z + 2-U Z6- Amount of Renters Applied For: l!! <br /> l�,ell <br /> Local Contact's Name: � Brown " <br /> �y 60 <br /> .� I,1 G oo �. <br /> Local Contact's Address: 2-� Za 60khSM ke R� w ' � ( �� 3 0 <br /> Local Contact's Telephone Number: &(2- 24 S- 20(P City State Zip <br /> Most Recent Burnett County License Number: STR- + 0 State License Number: fA_rC-P_ <br /> � W � <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: y o <br /> ►� LiCwSPA 'tS F)y- 2-O N i-Zv25-, <br /> UCensc res t -31-20Zla. er�e� year-��. C) <br /> 3 c, �'�v1,1� 11ds be ,S,ecured t,�i a 16c -4 C;uLt►n by '7-15 z <br /> 'Prdd $tc�h h eel S to be d i5aplayed a+ .Q.rndl of r�rive,tea c� <br /> YvceA Fee Rec:30b19b <br /> 2Y� Q 9u t dt�l rS tD Ike.- odd 6-Lt Sidi.V�-ea y �n fie- 0o�- ro ck#: t <br /> „L'` o-� Li cen5i n� r eq ,• wE 5 tz <br /> b� t7-is-2S• see L.e. Utz <br /> Date of staff site visit: lQ �"� Initials of site visit staff: LU � <br /> /n 7 <br /> LICENSE APPROVED BY DATE: l�f'7 � � C 00 <br /> < 3 <br /> LAND SERVICES OFFICIAL ---� <br /> CD C <br /> Page 1 of 3 ; <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 CD [ll <br />