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SHORT-TERM RENTAL LICENSE APPLICATION - Burnett County, WI r r <br /> CD <br /> a fD n <br /> Applicant Complete All Sections Below This Line <br /> E Oriyzinal License Fee =$300 ❑ Renewal License Fee (Annually) _ $150 _a <br /> Property Owner's Name: <br /> J <br /> Property Owner's Mailing Address 'm`� - <br /> ` City St to Zip �- <br /> Property Site Address:• b ' N <br /> Applicant's Telephone Number: <br /> Applicant's Email:t`j4e lJ CZ) <br /> **If staff has a question about th s'application,you will be contacted via email. Make sure your email address is o <br /> legible and your email provider will accept emails from the following address: cLBurnettCountyWI.gov <br /> Legal Description of Property: - t , L 9,- - 40 - 2 - 5 eD,5 <br /> Section#: Town#: _N Range W Town of. IN -1.12 <br /> *Attach additional a e i needed or fen•thv descr•i tion OR attach a co y of the deed OR attach fax systein properly,page-* <br /> PS .r f b P P P P' <br /> = w <br /> oa <br /> Tax ID#(1-5 digit number;found on tax statement): n <br /> o f 77—.T ) N <br /> < <br /> a <br /> Provide Rental Information ° <br /> License Year Applied For Amount of Renters Applied For: <br /> 1 (� q 5 <br /> Local Contact's Name:t �r t, /r b <br /> Local Contact's Address: i I1 N o <br /> City State 7,ip <br /> Local Contact's Telephone Number: <br /> ��-OSS6R9 <br /> Most Recent Burnett County License Number:_STR- State License Number: ° <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY N N v <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> 6 <br /> o C G u pa v\ey aj,�, a d�Uex�i se�nn� not -1� -e,�c e ecQ a z <br /> �u.eS -G Fv 5"7 *K <br /> Q � deJ��w�s tb be �os1 ou-- ode, we a.V rv144 h <br /> LU <br /> v w <br /> t� a -�'i Fee ReC:��rn <br /> v� douv 101� g �30 ) 2025• LS�ee LetfeY (, oe L�Ic�InSi Ck#: 1 C)h3 <br /> ►re�lre.w►e,�-s. T <br /> (ol I t,W akA UceviSl►v- r wires , m <br /> Date of staff site visit:�J�l's(�ZS Initials of site visit staff: ! <br /> LICENSE APPROVED BY lA�l DATE: ZS a tr <br /> css <br /> LAND SERVICES OFFICIAL < 3 I <br /> ccCD <br /> #L� <br /> Page 1 of 3 ; <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br /> CD <br />