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SHORN TERM RENTAL LICENSE APPLICATION — Burnett County. WI r <br /> CD <br /> Applicant Complete All Sections Below This Line <br /> � C � <br /> 0 Ori inal License Fee= $300 Renewal License Fee (Annually) _ $150Cr <br /> a <br /> pp AA �� d <br /> Property Owner's Name: b'�1 I u l� � +' l j V['vt�(� I v ►� <br /> Property Owner's Mailing Address: �"J L�C c'! v tLd� e_ LA vy L4 o LA w-451 MW <br /> \ � City State Zip A <br /> Property Site Address: 2 �� 1j Ve/L t 6e tt ✓ j�G SS !�V1 LJ 1 <br /> Applicant's Telephone Number: ° r <br /> Applicant's Email: ��� � 4 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov ' <br /> Legal Description of Property: \o�t l � c{Gl �� �V <br /> Section#: Town#: `�0 N Range#:�W Town of: J(^t le 5 a►- N <br /> o �- <br /> *Attach additional page if needed,for lengthy description OR attach <br /> -a�copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 3(6(e 0 + Corwr4- <br /> Provide Rental Information .. ° <br /> License Year Applied For: �� Amount of Renters Applied For: Z` <br /> Local Contact's Name: V 1 e, tt [j � CD <br /> Local Contact's Address: L'1 J�'� � i t t -�.�� 237 w o <br /> z City State Zip WP <br /> 9 15sz- <br /> Local Contact's Telephone Number: -� !e <br /> Most Recent Burnett County License Number: STR- a4-Ktate License Number, �' L"'�� � <br /> k <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: .� o <br /> a � <br /> 9t,Llde tees I�lj $-IS-2�• <br /> O b CCU pa_n a" 0.d 0 n of Peb E, <br /> d D <br /> Fee Rec: <br /> t L� Ck#:1 — <br /> x <br /> to <br /> Date of staff site visit: 30' 2-j5 Initials of site visit staff: <br /> LICENSE APPROVED BY 1l� DATE: ( CD <br /> LAND SERVICES OFFICIAL y C <br /> �o � c� <br /> Page 1 of 3 C <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br />