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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI i? r <br /> C <br /> Applicant Complete All Sections Below This Line <br /> � <br /> 0 /Original License Fee=$300 CST Renewal License Fee(Annually) = 5150 <br /> Property Owner's Name: � Vcw (J.��CC (�► <br /> �-�46 CAS Oh �. OVNIC�S�1 i (h r1 �5>1� rD <br /> r <br /> Property Owner's Mailing Address: City O,Q y <br /> C)ayd �tr� `5� Tom. '(1�7JWZ Stat ® Zip N <br /> Property Site Address: <br /> ' BSI- 61 S =�la <br /> Applicant s Telephone Number: o r �— <br /> g U <br /> Applicant's Email: 7 p,,,C_CCQ�_cia o1�gmw, <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: @BurnettCountyWI.gov a <br /> .�1 0 y <br /> Legal Description of Property:_ W V •�C-s b;�1 LA 40- 30 <br /> d <br /> Section#: 2? Town#: N Range#: `vV i own of: SW <br /> S S <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertv page.* -- <br /> I Q UQ <br /> a t <br /> Tax ID#(1-5 digit number;found on tax statement): 3 G51 1 C4 N <br /> ' < <br /> Provide Rental Information ° <br /> License Year Applied For: Amount of Renters Applied For: 0 <br /> I ZCtC1Crd� <br /> Local Contact's Name: <br /> Day.tau " <br /> Local Contact's Address: =TfO lItX11 o <br /> Ci State Zip <br /> Local Contact's Telephone Number: - (�5�-11 g �r'�O41 s s <br /> y <br /> Most Recent Burnett County License Number: STR-o��•"�' State License Number:� C� --b53ti33 ° <br /> a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY d ww o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: rn <br /> ��IS I i CQyES>e, �jcPl reS I 31- 2o740. <br /> °z z cn v 1 <br /> -Tb IS �o Ca*+Cn has a P bl,t C, &ILXV• �u ►� r�u,w�be r o .� <br /> ?la C6� (�v math eAkrL�1v\C�d oor fD k�- Pd d u�'i,�4-in <br /> Fee1 <br /> C�� �rY 'LoCcN C�7 fi Phone,nw�nl by g13o ck#Re[�/ <br /> ro <br /> ail LictKsiv\� V,(Ve mevris. <br /> � <br /> �^ w <br /> Date of staff site visit• ( 2S Initials of site visit staff:� 1 a D <br /> aaas <br /> LICENSE APPROVED BY DATE: 0 :2 3 <br /> m o <br /> LAND SERVICES OFFICIAL o o -:_ o <br /> v = rya <br /> ;3. ` cosy <br /> Page 1 of 3 CD [J�( <br /> Burnett County, WI Short-Term Rental License Application— Rev 11/2024 <br />