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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r r <br /> 6r �. <br /> a � � <br /> Applicant Complete All Sections Below This Line <br /> ® Original License Fee= $300 ❑ Renewal License Fee (Annually) _ $150 C <br /> d � <br /> Property owner's Name: Michael Jaszczak &Alanna Jaszczak <br /> Property Owner's Mailing Address: 16000 S Madison Avenue Gordon Wl 54838 <br /> City State Zip <br /> Property site Address: 28845 Mystery Lake Trail Spooner, WI 54801 <br /> � N <br /> Applicant's Telephone Number: 218-428-2830 (Mike) 715-817-8618 (Alanna) o r <br /> Applicant's Email: mjazman2919@gmail.com or alanna.pahos@gmail.com <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is x <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov <br /> Legal Description of Property: LOT 8 CSM V 13 P 205 (GOV LOT 2) o <br /> d <br /> Section#: 12 Town#: 40 N Range#: 4 W Town of SCOTT <br /> N <br /> 0 <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> �• w <br /> tro <br /> Tax ID#(1-5 digit number;found on tax statement): 17954 d En <br /> o <br /> c <br /> � c <br /> Provide Rental Information ° <br /> ,�(License Year Applied For: 2025 Amount of Renters Applied For: <br /> Local Contact's Name: Michael Jaszczak &Alanna Jaszczak ° <br /> Local Contact's Address: 16000 S Madison Avenue Gordon WI 54838 N o <br /> City State Zip o ,� <br /> Local Contact's Telephone Number: 218-428-2830 or 715-817-8618 <br /> N C�v <br /> Most Recent Burnett County License Number: STR-IQ to State License Number: ATPC-055099 "' J <br /> r � <br /> a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY d d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: S o <br /> • A � <br /> d, vE1r�iS��^ S oce� <br /> rio+ -b -e. cecd '{ p ei .� <br /> pc� a-d P� pl <br /> Per Sa y,,+ 242)")15 <br /> t- to Ma AV\tC 0ACed1Pt,LwApcd by $-15-15'. <br /> — or 9t,� an a,ti �4v be_ serV�Ced by B-Is-2�. d <br /> aFee Rec: 3L_,0 <br /> b Ck#: 2766- <br /> -ol1 a W all l.ic U&ffn r-e_&L rvwev\A S. <br /> Date of staff site visit: ((— I—ZQZS Initials of site visit staff: L6 Q - <br /> a Zo Zs `° W <br /> LICENSE APPROVED BY6� (D <br /> DATE: �`�"/' < - <br /> Cn cro W <br /> LAND SERVICES OFFICIAL o o �"� c <br /> '0 : <br /> Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br />