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•- SIIORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r r <br /> et <br /> Applicant Complete All Sections Below This Line y <br /> 0 <br /> 0 y A <br /> CI Original License Fee=$300 Cl Renewal License Fee (Annually) = S150 o. Z <br /> v <br /> Property Owner's Name: Brian & Jessica Uthe P^ 2 <br /> Property Owner's Mailing Address: 2782 Fairplay Rd Hazel Green WI 53811 <br /> City State Zip H <br /> Property Site Address:31363 Kieler Ln,Danbury WI 54830 0 61 S1 <br /> Applicant's Telephone Number:815-541-8941 c r` CS <br /> g 1 <br /> ous net <br /> Applicant's Email:lsaam @Y q 0 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is ri1x 0 <br /> legible and your email provider will accept emails from the following address:@BurnettCountyWI.gov `4' g <br /> Legal Description of Property:LOT 1 CSM 5067 VOL 28 P 261 RECORDED AS DOCUMENT 470013(NE SE) o <br /> . 12 .41 . 16 .Swiss Ty w' <br /> Section#: Town#: N Range#: W Town o :f <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 0 w <br /> C_- <br /> cro <br /> Tax ID#(1-5 digit number;found on tax statement):35832 d n o CI rt 4 <br /> Provide Rental Information <br /> License Year Applied For:2025 Amount of Renters Applied For® F. <br /> Local Contact's Name: Joe Kvidera <br /> ; <br /> Local Contact's Address: 24740 State Road 35 70 N. Siren, WI 54872 N n <br /> p 715 791 9227 City State Zip �o " <br /> Local Contact's Telephone Number: ,,`` — Z <br /> Most Recent Burnett County License Number: STR- State License Number:ATCP-054850 <br /> _ <br /> IV J <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY v o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < -3 o <br /> 0 L c, tres I- 31-20210. 'Re-MO ovn 2-1-2o210• y <br /> w <br /> D 0 CCU cum,. Q,dv2� -lse.W4-fr s not- Igo •ex-ceed t Z Diem-8 w <br /> o z �• N <br /> IhCIt tdi LAv &IL ldy e v► pee- SW-2-3=1`1• z <br /> ® Rein-l-a 9Lt.idelineS tc,be. posed blt-A-S►d A V\&L it zotrunce, door <br /> b(612-tS-2u25. See I dice- " L" g ItcevlSlen r Q wre elo.►c5, t <br /> v <br /> Fee Rec:t .b0 <br /> b Ck#:ON O 1 D <br /> rh <br /> Date of staff site visit: II I)o/zoZ 5 Initials of site visit staff: kla c <br /> r <br /> v <br /> I,, c � <br /> LICENSE APPROVED BY (5 DATE: I (-Zl.(�`�ZJ a: <br /> LAND SERVICES OFFICIAL m° , Tgil <br /> Oo cn <br /> o <br /> Page l of 3 - <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 31 <br /> a =I <br />