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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI C4 r <br /> Applicant Complete All Sections Below This Line _• <br /> Ner <br /> 0 c el) <br /> D Original License Fee=$300 )4 Renewal License Fee(Annually)=$150 a a <br /> .E3 S <br /> Property Owner's Name: *NIA tidal C3 l a amen '40 1 <br /> . C <br /> Property Owner's Mailing Address: I 1A Id i Xr . k V N 55315 y <br /> 52e s C dory goad Danbveyeityw S u83dZip <br /> Property Site Address: t <br /> ' <br /> Applicant's Telephone Number: (O 2- 915- ^I01 c0 5 o r <br /> Applicant's Email: cimstada • b\oaMer 04 9m61i1 • corn en <br /> o <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is V <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov g <br /> }L•0t2C6, 1l 3 o VUP P1i5'(ovLaI')4t310 r <br /> ag <br /> Legal Description of Property: p <br /> Section#: l B Town#: (413 N Range#: IS W Town of: TQMO11 I! <br /> *Attach addition^!��^e if”eea•d`^ic> Y7vthv.Jer,.ri tio'OR attach a cagy of f the deed OR attach tax svctem property nape.* I.- <br /> ��jj,,,, <br /> Tax ID#(1-5 digit number; found on tax statement):Sain 3 n O <br /> c) o <br /> - <br /> Provide Rental Information °- <br /> \if,toySti ___. ci, <br /> License Year Applied For: 9.025 ilia Amount of Renters Applied For: <br /> Local Contact's Name: S' ,vt, 6Q,\tS <br /> po -f � <br /> i. <br /> Local Contact's Address: 2:1V)0 I S {-e Fd a s 3 S \ bsi'd/ 1N I 54013 p z <br /> City State Zip <br /> Local Contact's Telephone Number: 1 i5 -S Z t0 - 21 1 t4Wwcia-iri-Cc `1) <br /> 1� (_ p�- <br /> Most Recent Burnett County License Number: STR- 2%-- 1 State License Number: t�l VI' -Q I� P11a p `,, d <br /> :a CQv\k- derwl 2a L�l 4 a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < o <br /> CD LlCt?,tA,R, 'exi)►reS 1-31-2024.. y <br /> CD DC,C,ZciA at/tot ad er iStionvA-ks' A"o ..ucceed 4 c ikas-Es, z z <br /> i(��g, <br /> 0 ' uvk- t �u;tddine s -b be posted 6 Ltkeiciee Inear rvta-A" •e.� `ce' _ U.)door- bt3 to-IT-2025• Ste. Letter w L`" CC i�IwAstrtGJ f U,tre"..axd'S. <br /> - Fee Rec: /50 - <br /> 0 out— per, b y La tce. to be. rewtovect -- r�?A9e -�ed bio I2-1-25, Ck#: (30 <br /> 5 i&&.l �u,tdel1t.eSP(aorkei f0 (oe o fda�red Correct-ions b� ID-3o-2S <br /> CSce, vie sow 5ui4 cotes) l J <br /> " 2 3-G 5 r <br /> Date of staff site visit: Initials of site visit staff: L-r- -I- IZ - <br /> CD- 1 HI <br /> . <br /> LICENSE APPROVED BY •tu1la DATE: q-Zi-2-c $ g = �'���,,�n,v�' <br /> LAND SERVICES OFFICIAL v o O <br /> Page 1 of 3 CD <br /> 3 [fa <br /> Burnett County,WI Short-Term Rental License Application-Rev 11/2024 <br /> 10 apk1c,*t \i d -a be Secured w c-4k a Lout_ -f- ciAlitAA laj l0 3o-25- <br />