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CA <br /> r <br /> F FD <br /> a CD n <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI I: ° <br /> c4 er4 <br /> Applicant Complete All Sections Below This Lined z <br /> C <br /> P. C <br /> Original License Fee= $300 Renewal License Fee(Annually) =$150 v ;5i <br /> Property Owner's Name: illi"`^^ g?tJ4d t''1 <br /> p rty " <br /> " `�— . j..-'41 ie,., /e OW n Z <br /> Property Owner's Mailing Address: <br /> 1 i ' C� l 3 �� <br /> � City State Zip c b <br /> o <br /> Property Site Address: Zq /�"A4 cv �� stf8vZ-- <br /> F') <br /> 1p <br /> Y5 Applicant's Telephone Number: &(Z 3i? 1 ? `f 5 into O <br /> k <br /> Applicant's Email: ]3)/1 kali- `''1*4 6.i(l '2 o• a <br /> S <br /> Legal Description of Property: d <br /> Section#: Town#: N Range#: W Town of: `, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d n N <br /> vn <br /> Tax ID#(1-5 digit number;found on tax statement): eq. C ' <br /> '. <br /> o 4 <br /> Provide Rental Information CA lir <br /> License Year Applied For: �U 2,1r> Amount of Renters Applied For: 1 5— <br /> -o <br /> Local Contact's Name: It /../`` Fier - I <br /> q <br /> Local Contact's Address: /L' 3 9k-1/4""" )/ jU'le-C' c— J73CV 0 <br /> ,� 6-111 ",:o" City State Zip <br /> Local Contact's Telephone Number: l <br /> p <br /> Most Recent Burnett County License Number: STR- 1 b.... 61 State License Number(114//6")( / A - <br /> C <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: (i) •oo <br /> P/OLC et d. to be. c-elp ec 11 di5playec( b <br /> z <br /> ze. i e vl� <br /> �t tit_ ql/a0a0 - <br /> H <br /> . <br /> � <br /> rd Fee Reel'1513 <br /> z34G ntkh,zt P <br /> Date of staff site visit: 5 (949°(949°1 Initials of site visit staff: ` rn --1 LTD <br /> LI ,, <br /> LICENSE APPROVED BY 5/610010 _ -� � <br /> LAND SERVICES OFFICIAL o m -fit Ic <br /> -1 111 <br /> t•:: N <br /> ' <br /> m '< N L: <br /> O p <br /> Page 1 of 3 > ___iFi <br /> Burnett County, WI Short-Term Rental License Application—Rev 1/2020 K <br />