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SHQRT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r <br /> r <br /> eD <br /> G �' A• <br /> Applicant Complete All Sections Below This Line <br /> 'o' <br /> ❑ Original License Fee=$300 Renewal License Fee(Annually)=$150 o a c <br /> d <br /> Property Owner's Name: - <br /> Property Owner's Mailing Address: l,q <br /> Property Site Address: ��� 'i j o Y1 "� /porww- ' QEk L n <br /> N <br /> VI <br /> Applicant's Telephone Number: C.Ji r <br /> Applicant's Email: �--�1 I�V\ G (�✓ �— � ` t C-0 KP-1 <br /> **If staff has a question about this application,you wi be ntacted via email. Make sure your email address is 0 <br /> legible and your email provider will accept emails from the following address: @BurnettCCQ yW�ggv P q <br /> I ( t4e-rsoYv ( i © �-f <br /> Legal Description of Property: � L'G 6 ILA <br /> Section#: [­!!) Town#: �N Range#: W Town of: S 4-6tt <br /> TT� lB <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. . 4, w <br /> CC U <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> a <br /> Rental Information ° <br /> License Year Applied Fo . B A nt of Renters Applied For: a <br /> Local Contact's Name: L;��4,u <br /> b <br /> as _ <br /> Local Contact's Address: flit 1fYLP 0 9 z <br /> City State Zip G <br /> j <br /> Local Contact's Telephone Number: l.� 1 Z-Z�d�l�'�—o A x' <br /> -rcp- o l i e7o 2- W <br /> Most Recent Burnett County License Number: STR- State License Number:LA <br /> L N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 4 o <br /> C�VS 2oZq + 2025. N <br /> y <br /> 3 0M OL verb nod +o.QKCeed lv �ues+s per- m <br /> D gyp. <br /> v <br /> ��{J '4'i� D IDF. U da-t�et 'f"D Co r✓Pvt I1 et v►tiber p� J(OQ�S '� Fee — <br /> Ck#:� <br /> per S�-,tJ-jk- 353up bl� ? 90-2021p. <br /> m <br /> Date of staff site visit: 7 1 Z�ZS Initials of site visit staff:4p <br /> LICENSE APPROVED BY � DATE: l� ��-Za ZS <br /> a A <br /> LAND SERVICES OFFICIAL m cc -0 <br /> Z3 <br /> CD <br /> Page 1 of 3 00 0CD C <br /> 0 <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 c <br /> � U, <br />