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'--'4j*1ORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI c r✓ r <br /> Applicant Complete All Sections Below This Line <br /> 13 Original License Fee=$300 Renewal License Fee(Annually)_$150 a = <br /> Property Owner's Name: AS�l.c ui W CtX S� <br /> Property Owner's Mailing Address: <br /> City State Zip y <br /> Property Site Address: 5 -7 6Y1 l-Y1 Ilk*x A 1 S y $3[� o <br /> Applicant's Tele hone Number: <br /> P <br /> Applicant's Email: OjS�,l P,c^. }gyp W 0L1 S 01 YY1,M Cgrv1 Q <br /> **If staff has a question about thif application,you will be odntacted via email. Make sure your email address is x o <br /> legible and your email provider will <br /> accept emaiils from the following address: @BumettCountyWI.gov V � <br /> Legal Description of Property: <br /> o � <br /> Section#: Town#:__!�Z_N Range#: 9 Town of: <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* w <br /> Tax ID#(1-5 digit number;found on tax statement): `Z21P D�o Q N <br /> C <br /> ^� Provide Rental Information ° <br /> License Year Applied For: 6��d Amount of Renters Applied For: <br /> Local Contact's Name: g 121(im 15c, <br /> Local Contact's Address: lD"�gU � D1•(� 6q<3 30 0 <br /> ll City State Zip <br /> Local Contact's Telephone Number: 1.(t)off- Oil- b 76 Z ,/it 1 C�, I S te 3 5 <br /> y N <br /> y <br /> Most Recent Burnett County License Number: STR- State License Number: <br /> a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> n � N <br /> Octit <br /> >1�k hCCeecl uPS� ►v�Cluc{�h o z <br /> A&I { -h VY— Upd&W fD Cc(reef- Y1Lumi er of Otcd;94- fs f ',- <br /> evi�tS < <br /> Sai,*252-W blj W-3o-2tab�. CMe Lq*?efs t ttIL(hed) d - <br /> n Fee Rec: <br /> �laCclrrd t�ev�ta 1 guidel'I��S t� b� v��clate�t w�Jrn ��rrec stcri,e���cep�s� b ek#: <br /> 0U,vv,,ioev- + Cuvr6l-Cw v, h,3 Lice4j�e, V\LLmn wv-JCy 10-3o-2S. <br /> Se(AjL•task W be� vvwa vwzuj -%(ed .Serviced Ixj I I-'30--2o2-&- <br /> Date of staff site visit: '11' � Initials of site visit staff: 3T L ` <br /> m <br /> LICENSE APPROVED BY l DATE: - Z-Zb Z� <br /> LAND SERVICES OFFICIAL ` <.3 <br /> CD = <br /> CDCD <br /> (0 <br /> 00 C7 <br /> Page 1 of 3 v o <br /> Burnett County,WI Short-Term Rental License Application— Rev 11/2024 a ` L <br /> CD <br />