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ADDITIONAL PROVISIONS <br />• FAILURE TO COMPLY WITH ANY OF THE BURNETT COUNTY CODE OF ORDINANCES MAY RESULT IN <br />IMMEDIATE REVOCATION OF THIS SHORT-TERM RENTAL LICENSE, WHICH WILL CONSTITUTE AS A <br />CEASE AND DISIST ORDER. <br />• THIS LICENSE WILL EXPIRE JANUARY 31', 2019 <br />• BY SIGNING BELOW, OWNER AGREES TO ABIDE BY ALL SHORT-TERM RENTAL LICENSING <br />REQUIREMENTS <br />• THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT TO ACCESS AND/OR <br />REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT. <br />I (owner) declare that this application (including any accompanying materials) has been examined by me, and to the best of my <br />knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information <br />contained in this application (including any accompanying materials), and I further declare that I recognize that this information <br />provided will be relied upon by Burnett County in determining whether or not to issue a license. I accept all liability that may be a <br />result of Burnett County relying on the information I am providing in this application. I acknowledge that I will abide by all <br />private/public covenants, restrictions, leases and easements which may apply to this parcel. I agree to permit county officials charged <br />with administrating county ordinances or other authorized persons to have access to the above-described premises at any reasonable <br />time for the purpose of inspection. <br />---ADDITIONAL COMMENTS FROM OWNER ALLOWED HERE--- <br />c3 <br />OWNER'S SIGNATURE: <br />Property Owner is required to sign and date this application. <br />(DATE) <br />SUBMIT COMPLETED APPLICATION, MATERIALS, AND FEE TO: <br />BURNETT COUNTY LAND SERVICES <br />7410 COUNTY ROAD K, #120 <br />SIREN, WI 54872 <br />APPLICATIONS WILL BE ACCEPTED VIA USPS, ANY STANDARD COURIER, OR IN PERSON. PARTIAL OR INCOMPLETE <br />APPLICATIONS WILL BE RETURNED TO THE APPLICANT. NO EMAIL OR FAX APPLICATIONS WILL BE ACCEPTED. <br />ONLY CHECK, MONEY ORDER OR CASH PAYMENT WILL BE ACCPETED. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED <br />AT THIS TIME. PLEASE, MAKE CHECK PAYABLE TO: BURNETT COUNTY LAND SERVICES <br />Please call the Land Services Department if you have questions. 715-349-2109 <br />Burnett County, WI ordinances can be found at: http://www.burnetteounty.com/index.asvx?NID=1043 <br />Page 3 of 3 <br />Burnett County, WI Short -Term Rental License Application— Rev 4/2018 <br />