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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI � r <br /> Applicant Complete All Sections Below This Line <br /> 7 H <br /> ❑ Original License Fee=$300 Renewal License Fee (Annually) = S150 a z <br /> Property Owner's Name: 0M € �nkt4 i a <br /> ` X <br /> Property Owner's Mailing Address: ��' (,mi l (s 15L' \ <br /> City State Zip Q <br /> P 01595 5 I-} 9 yi-�Y\ 0-4 <br /> Property Site Address: 0.�� o <br /> Applicant's Telephone Number: rJ'Jf�� �ZJ C lJ o r <br /> Applicant's Email: U,610od ( 0 \ Q._ D 6 , C-Or" 1 <br /> **If staff has a quest n bout this application, ou will be contacted via email. Make sure your email address is x 0 <br /> legible and your email provider will accept emails from the following address:@BumettCountyWI.gov <br /> Legal Description of Property: Q iC own AP D fiD Vo uQgCV Yj r'tocg& 1-6'f 1 7 <br /> o <br /> Section#: f3 Town#: N Range 15 W Town of: �Ac ks Q�- ._. <br /> *Attach additional page if needed for lergt;,y dcscripti;,n OR attach a copy of the deed OR— a!t�systcm property page. <br /> afro <br /> Tax ID#(1-5 digit number;found on tax statement): 7 Lf SS r) N L_. <br /> a <br /> Provide Rental Information <br /> y <br /> License Year Applied For: 2.00S Amount of Renters Applied For: <br /> Local Contact's Name: I�e P <br /> Local Contact's Address: '! ��Q 1 \�l)1- z <br /> City State ZEp � <br /> Local Contact's Telephone Number: L <br /> Most Recent Burnett County License Number: STR State License Number: <br /> r <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o W �` <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> � o <br /> z O CCu.�bjCl ",ut -ey-c eed �' roues+- o z <br /> Pear SAN— -Z(o. <br /> 4tuW. tD <br /> ()kva TO � vPGfAI'MWIj'1orrett—M o <br /> FeeRec:15a. DO <br /> �e lt1Q <br /> I V1�Orl'Vl�1"1�7Y1 ('Jl� Id' l5 2Jr. 5� 5�1�e a�C�cQ> 4 Ck#: <br /> SeCux� Do e- Se ic,ta�� - LA b�) i0 <br /> Date of staff site visit: Initials of site visit staff: J "''--' <br /> m <br /> n � <br /> LICENSE APPROVED BY 41 DATE: <br /> LAND SERVICES OFFICIAL Cn m <br /> �c <br /> O 2 <br /> Page 1 of 3 n <br /> CD <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br /> CO AaQ e,+-Isemn P_vits +c bt u pd-al:ed 4D Corree_+ R Ltm be-- 0 OaAlxP" <br /> Per SRlQ•-Zi-Z(o by [Q-(5-Z5 (see _<_4we s a0aclWA) <br />