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ART-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br /> 4 Applicant Complete All Sections Below This Line <br /> a° <br /> a iginal:License Fee = $300 ® Renewal License Fee (Annually)_ $150 g <br /> d <br /> Property Owner's Name: �Qry V�,j �_C_&c A Me-&Ky— <br /> �ne i <br /> Property Owner's Mailing Address: 917 0S�" G�A <br /> City State Zip <br /> Property Site Address: r�7267 � j hh Cl -. C �i- �/� ���! 3 o <br /> 6/JL Applicant's Telephone Number: V 31-7 f 8 Z <br /> /� r <br /> Applicant's Email: �'t5' t� �M Cam. e r <br /> **If staff has a question about this application,you will be contacted via email. Make sure fur email address is K o <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI. ov <br /> {� 0f l u.� ,grlk�eua�i_CW9411iALM M4 3 Des (n If o� <br /> Legal Description of Property: A t iL V, � #J�_ 1 <br /> Section#:�Town#: N Range#: W Town of. �`�,nd <br /> *Attach additional page if neededfor lengthy description OR attach as copy of the deed OR attach tax system pro page. R. <br /> Tax ID#(1-5 digit number; found on tax statement): 1 J J U y? o <br /> Provide Rental Information "' o <br /> License Year Applied For: Amount of Renters Applied For: . <br /> Local Contact's Name: V\V%z <br /> b � <br /> Local Contact's Address: a'2 0377 �,y�,T� p (�,1 S�Qf 1 o <br /> � City State Zip <br /> Local Contact's Telephone Number: 61 Z. �S7 to z <br /> I h I <br /> Most Recent Burnett County License Number: STR-�J�,V/ State License Number: -625SO �' J <br /> J <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY =! � <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Lt, VISA QYp re-S L- 3(• 2 0 Z (p. -F <br /> per, „ Cz" CL6o- rklsea�v +. ono+ -Vo �Cefd <br /> c5� ��'1-7 1 . z z <br /> O �v�l ot� 0.�- l�.,ce.,v��c,�n� r e,�i-u�e�v�.e�s• � � <br /> U � - <br /> a Fee Rec: ` '6 � <br /> Ck#: <br /> x <br /> r- <br /> Date of staff site visit:3N 0 Initials of site visit staff: La <br /> a D <br /> C <br /> LICENSE APPROVED BY DATE: ���J�d� <, M <br /> o <br /> LAND SERVICES OFFICIAL c <br /> CD 0 <br /> Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br />