Laserfiche WebLink
SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI c cr <br /> .Applicant Complete All Sections Below This Line ` . D <br /> Igi Original License Fee= $300 0 Renewal License Fee (Annually) = $150 A a <br /> Property Owner's Name: pG ier-S'o 'JS pj`p je (Ali � <br /> er T<<S � kin �G)"' ="` .—cr <br /> / c— ow <br /> Property Owner's Mailing Address: /2,A y g" ,Z.2r►d Slree--f AI 4:Ike c/4 o M N sSbV 2 . <br /> 1 City State Zip <br /> Property Site Address: 26��41 1orttee// A.tit �flmpq�' WX' S'yea/ o p N <br /> VV !! !b <br /> Applicant's Telephone Number: b I.Z. A©J // (1-2 .t r� C'T� <br /> v1 <br /> Applicant's Email: IN e`e_rsc 's Q rap.f 1 C a-esTh4//' C,om 6, <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is 0 <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov :• <br /> g DescriptionProperty: Lo 7 a esi V D P3. Z 8 r g <br /> Legal of Pro e ° <br /> Section#: JQ Town#: 3 9 N Range#: /'( W Town of: it S Ad c-t <br /> ry_ <br /> U� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* E. -- O <br /> go <br /> Tax ID#(1-5 digit number;found on tax statement): /5 7 9 b n o VI <br /> q 18), <br /> Provide Rental Information ° t <br /> 1 �go <br /> License Year Applied For: (-9� Amount of Renters Applied For: It LJ N w ill <br /> 1 <br /> Local Contact's Name: R102 <br /> %, yso�1 <br /> S. 0tr P z <br /> Local Contact's Address: o E <br /> City State Zip <br /> Local Contact's Telephone Number: 7--r. ‘0 15--SU)(0-055 (-- <br /> v,v7! <br /> Most Recent Burnett County License Number:_STR- N State License Number:A:re.P 0S-5"74/1 rn o c n <br /> r <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o O x <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> CI Perms -kr IS Coy 20 ZS 1 Zo2-( . k�eneu.) a).n 2-1-2 0Z-7. <br /> 2� O CCA Tagc c6 oLn6. MOelrllseW Q & n c* to .e,Kceed Lo .3u.els mad T z z pev �., <br /> � c <br /> III Y\ 4 c �'l . t <br /> .Rex* U TActeA1 r$S kb 1C2 Tested oui side v\ea,Y WW1 d24A4-vaAce, -- -- <br /> d,00Y ic., l2• V -2o2s. See. Letter "L" tic I ►Ce.NSivn I'>?y lltre,Yv►evks, ? Fee Rec: <br /> (, Ck#: 1 7: <br /> 0 k l o .-) a.a CA.c ean.5l►j r'e ve-vv��'k.s ' A <br /> r, <br /> � U <br /> Date of staff site visit: t I/��//✓Q 0/2W� J Initials of site visit staff <br /> 'I Q :71(...e.z.)..,IM <br /> LICENSE APPROVED BY : (11/1 �.6.�� DATE: I(-y-ZO 25 m W <br /> LAND SERVICES OFFICIAL e a — t� <br /> 00 <br /> n — uu� <br /> Page 1 of 3 I <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br />