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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Orip_inal License Fee = $300 <br />Property Owner's Name: E t LL <br />Property Owner's Mailing Address: - 1 <br />Property Site Address: <br />Renewal License Fee (Annually) = $150 <br />rr V�1a - .�0IT 4�y <br />Applicant's Telephone Number: <br />Applicant's <br />Applicant's Email• [jl � � 6)�.? O(� U `� �s (� on <br />iIll� Mti 5 <br />City State <br />Legal Description of Property: <br />Section #:_ Town #:-4D N Range #: I �_W Town of: S <br />*Attach additional page if neededfor lengthy descriptiOn OR attach as co, -)y of the deed OR attach tax system property page. <br />Tax ID # (1-5 digit number; found on tax statement): 1 - l lD 3 '.; -1% <br />ll Provide Rental Information <br />License Year Applied For: Amount of Renters Applied For: <br />Local Contact's Name: / F v ~� <br />Local Contact's Address: & 1-/1,6t j /�,_ raj dc <br />(���� <br />Local Contact's Telephone Number: (� Z- City State Zip_ [ <br />�AA cy_ �YkLZ r <br />Most Recent Burnett County License Number: STR- State License Number: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />v <br />r� <br />Date of staff site visit: 9 Initials of site visit staff: <br />LICENSE APPROVED BY DATE: <br />LAND SERVICES OFFICIAL <br />sL� <br />Page 1 of 3 <br />Burnett County, WI Short -Term Rental License Application— Rev 4/2018 <br />r <br />Fee Rec 10 <br />cid,. 3363 <br />