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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County. WI <br /> c r <br /> Crru <br /> r.. <br /> Applicant Complete All Sections Below This Line 01 y <br /> XTOriainal License Fee=$300V w cen e e �11 50 iz C <br /> Property Owner's Name: J,, /7 y e <br /> Property Owner's Mailing Address: M N,S53o � y <br /> p City State Zip <br /> Property Site Address:) off' / 3 s l� �Y� b y t, Z <br /> Applicant's Telephone Number: .3 15-� o _ /1 <br /> � ^r1 <br /> Applicant's Email: 4'i 0 M I�4 /e A 0"v S - G 0,-, <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 address:@BurnettCoWtyWI.gov <br /> R e�-�/1 U <br /> y o r o <br /> Legal Description of Propertf 3 C.S`y j 5-3�®L 3 O R'T G oT <br /> Section#: 5 JC> Town#: !-f N Range#: !!v W Town of: y <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* ? <br /> � w <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Provide Rental Information ° <br /> License Year Applied For: Amount of Renters Applied For: <br /> Local Contact's Name: L'O ^� Fr b, q <br /> q _ Q <br /> Local Contact's Address: / -� 5 3 .J j�", 6 <br /> _ City State Zip � <br /> Local Contact's Telephone Number: 7l5 3 �O©� � Zip <br /> Most Recent Burnett County License Number: STR-22-0 Z.. State License Number:/9 T C-P-0 Oct 52 8 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < o <br /> Li cWse- 'wires Q o <br /> OaC,v a O' n Cj'&LWv'h ?_W\e K n6t � �k. eex4 g ��� o <br /> r z .o <br /> � <br /> 0 ptacavLi ntaa- Yvta h W{r&"ce, door fib be. U dialed W c4+1 <br /> m <br /> cu.mrvt- 5ka� Gc�� Yumt-tr 0►.4 eouw�j �cev�se� - <br /> q Fee RecAp0.06 <br /> by g-15 25'. Ck#: 2oC1i3 <br /> rd <br /> m <br /> C�►n-t + W, t )tjR N fpee. tabe sakid reanfig ---- <br /> pluced akc, "_5 +IAc S ►.cv l Vtnb• �=J <br /> Date of staff site visit: Is,-t 2� Initials of site visit staff: l.F� <br /> LICENSE APPROVED BY DATE: 3 Z v <br /> LAND SERVICES OFFICIAL a "' M <br /> �0 c a <br /> c <br /> Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 3 <br />