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r C" <br /> 5. 8 ... <br /> a n <br /> SHORT-TERM RENTAL LICENSE APPLICATION— Burnett County, WI �: <br /> Applicant Complete All Sections Below This Line = c'. <br /> d g <br /> Original License Fee $301 Renewal License Fee (Annually)=$150 ',J A <br /> Property Owner's Name: Lae/1 3-oron i , y <br /> Property Owner's Mailing Address: l4O a a C-h,)'Ulu M Scut EV_M mixt W1 9-1151 $' o <br /> J City State Zip t ' <br /> Property Site Address: a°I i?t3 1(02-►c LOUd 1)avilo ..tn \A-x- 9+s30 <br /> Applicant's Telephone Number: -its -aaS -aS5°I o <br /> Applicant's Email: I1rdQh5alSibYV1►IOY11C.S e c\VVictI • c0-yvx . `° <br /> Legal Description of Property: pQYC(j of(nyld I occaut t n gpovv evi{- I b1' A d -C <br /> Section#: Town#: 40 N Range#: (4 W Town of: 5 CcsH" c <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* opo <br /> c. n o <br /> Tax ID#(1-5 digit number;found on tax statement): I 1'B i i- 4. o <br /> \V fr- <br /> Provide Rental Information i ��,, c c <br /> License Year Applied For: a O a 0 Amount of Renters Applied For: .i- y <br /> uc <br /> Local Contact's Name: C M& Me l On 0Yl I <br /> Local Contact's Address: acl°le. S IrlbrZll✓Ie.I/v►J e VOto l oae.. \i\r" . 51113o <br /> City State Zip <br /> Local Contact's Telephone Number: 11S -R501-'7113 <br /> Most Recent Burnett County License Number: STR- State License Number:NG L -IIjQ9�77-,F <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS,LISTED BELOW: g -- <br /> 8° ()CC UaV\.r: ‘I'/Y\,--r\--- o 5 Li C .+lie be-Sec c YTh\ ,--.1 <br /> tvJ a \Deck coop n u' () Sag�--te I z oQ <br /> • Ott+5-1 a p 14_carcK (sQ.e_ ‘..1._it on „Ai°. <br /> (e lA, f e wA.Cve- - ‘c,_c_.- 't, I, 0._Q -o <br /> Pi <br /> Fee Rec: ' `p <br /> g <br /> cA x -203/ <br /> Date of staff site visit: ✓ — Mals of site visit staff: �\0\\� <br /> m <br /> \elf 440,- <br /> LICENSE APPROVED BY : DATE: -� c r- <br /> m <br /> LAND SERVICES OFFICIAL g a <br /> 0 <br /> P s3 a <br /> r VG <br /> p 2 <br /> Page l of 3 d 4c' roa <br /> Burnett County, WI Short-Term Rental License Application-Rev 1/2020 1 <br />