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. r+ <br />SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Oril4inal License Fee = $300 Renewal License Fee (Annually) = $150 <br />Property Owner's Name <br />tv i I b o,*- <br />Property Owner's Mailing Address: <br />Property Site Address: l �✓ 1 <br />L q A y Una 7 <br />City State Zip <br />.,el- 4,.-%-- 1VeF0_ <br />Applicant's Telephone Number: & \ Z <br />Applicant's Email: %11"'���' <br />Legal Description of Property: <br />Section #: Town #: i 0 N Range #:W Town of: r✓p <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />Tax ID # (1-5 digit number; found on tax statement): <br />Provide Rental Information <br />License Year Applied For: /1 Amount of Renters Applie For: <br />Local Contact's Name: T"I <br />Local Contact's Address: <br />/ (� City State Zip <br />Local Contact's Telephone Number: (Q J /! InIncy-11 Y�lDC a-T <br />Nim <br />STD-►�'- <br />Most Recent Burnett County License ber:_STR- O1 1 ate License Number: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS LICENSE IS SUBJECT <br />� TO ALL CONDITIONS LISTED BELOW:: <br />� �7. X � (� � l �t /'[�✓�N� W N IUn I'S N '!.-4 N "�'�� I a� Yl � /�' l�C. <br />MOV`C� XV Q IOCA��/j O A !t-A Mil W/ 4/I S�9 t7Q <br />�y 1/►/Za zo, <br />Pia Ga r� �Z7 Ot p!i»» Ot��y �u 9i <br />Date of staff site visit: 61,yl Initials of site visit staff: 2, <br />LICENSE APPROVED BY DATE: 7/1 <br />LAND SERVICES OFFICIAL <br />Page 1 of 3 <br />Burnett County, WI Short -Term Rental License Application— Rev 1/2019 <br />0 <br />a <br />d <br />0 <br />r <br />0 <br />91 <br />n <br />a <br />C <br />O <br />N <br />O <br />N <br />O <br />b <br />z <br />d <br />ti <br />f <br />vV <br />Fee Recl tsT <br />