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SkORT-TERM RENTAL LICENSE APPLICATION - Burnett County, WI r <br /> � r <br /> Cr CD n' <br /> Applicant Complete All Sections Below This Line C <br /> � c � <br /> ❑ Original License Fee=$300 Renewal License Fee(Annually)_$150 a <br /> Property Owner's Name: y6� � <br /> Property Owner's Mailing Address: e <br /> City State Zi <br /> Property Site Address: V o Q <br /> Applicant's Telephone Number: <br /> Applicant's Email: � � ;fir y. .2�. C� <br /> **If staff has a question about this applica4on,you will be contacted via email. Mikeyre your email address is o <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov <br /> Legal Description of Property: <br /> 0 <br /> 3 �~Section#: Tow. Range#: _W Town of: <br /> N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 2-0< a o <br /> Provide Rental Information ° <br /> License Year Applied For: �'°�� � Amount of Renters Applied For: C <br /> ' Tk � &-,aAr G N <br /> Local Contact's Name: cy /� ,� � <br /> Local Contact's Address: �--7 � � � � V 3, \Jc �� z <br /> City Statee ip — <br /> Local Contact's Telephone Number:� `�_— — \ _C� y 5 <br /> Z -0 ft"c�- ot1Ng� <br /> Most Recent Burnett County License Number: STR State Iicense Number: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: s <br /> e— GSA Zo Z!o m d <br /> DGG uP q K cy q►a OVIW* .,15 twi� N 0�7'� L�Cc cCa' ��� ; N <br /> 3 guy jdu5e- canNvf ?cr Axe. <br /> © g em;CI/ Lt►NYC/!I q -1v (7 c UPC .Aa E /1 I Zo z,J <br /> ! a Fee Rea I D <br /> 4 Ck#: <br /> x <br /> m <br /> Date of staff site visit: ZOL,- Initials of site visit staff: i Li� <br /> Q <br /> n D <br /> LICENSE APPROVED BY DATE: S ZO ZS m 03 <br /> <. <br /> LAND SERVICES OFFICIAL m ` c <br /> o0 o <br /> N_ <br /> Page 1 of 3 cN <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 CD �]1f <br />