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CA <br /> r <br /> r <br /> SHORT-TERM RENTAL LICENSE APPLICATION— Burnett County, WI I: n- y <br /> Applicant Complete All Sections Below This Line .- °- <br /> d 2 <br /> Original License Fee= $300 Renewal License Fee (Annually)=$150 " ft <br /> Property Owner's Name: nalh`cl A/ e ir-\ <br /> Property Owner's Mailing Address: /007 kJ 1.1--1-- 5* ,01)! 1'1 4//)33106 0. k-< ilW <br /> x <br /> city State Zip o r---. ' <br /> Property Site Address: �5/Y ?et Rd �4 r `,C� --5z/S�f°3 r <br /> / I <br /> Applicant's Telephone Number: /2 '—22 "3 /// t:?-- r <br /> Applicant's Email: J2 M k�� ' ` /)(C�, ( /C 0/0 =° <br /> n r o. <br /> Legal Description of Property: ,L? b„r div' I backs /(-'P rs 4-biM iS 2e13 10 it, /z SA,/ d I+ <br /> i <br /> Section#:5.33 Town#:140i/N Range#: g!1 cv W Town of: 0 c k 4,4d- o <br /> 0 i <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* ado <br /> Tax ID#(1-5 digit number;found on tax statement): 53 43 I g, i N fV <br /> Provide Rental Information <br /> License Year Applied For: c202/ Amount of Renters Applied For: 8 5 0 e)'r/S <br /> i ; <br /> t -e <br /> Local Contact's Name: 1q/64 L/ 6 O r l e5 0 /� 2 i. <br /> Local Contact's Address: . /?V4.25— �a/14 /7 hake /ems+ /41,6 .5 W/ 505' ° <br /> p 6 l �7c -,Q0 l^ City State Zip <br /> Local Contact's Telephone Number: ((� r�Pica <br /> r3 <br /> Recent Burnett County License Number:_STR- State License Number:kL /© (1-A ! iV r3 H <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLYH <br /> b <br /> THIS LICENSE IS SUBJECT TO ALL CON ITIONS LISTED BELOW: F <br /> 0 f6t 15 r IAN 1y— .p�jc i` Dpi ! 31 ZOLZ, O w <br /> Z wait, S 94AM /. 5/E.G. c✓' quesA, hode?&id� z 7r Wo yYA � <br /> , � S. <br /> I.ocle,aaI cite i 14 7177 6e- /.t$4/<Gd OH S,oTTG / n4 <br /> 0 <br /> to <br /> Y C/!/222.Is <br /> il <br /> am Fee Rec: 3(�t� <br /> o CK 731a6- <br /> V/ / <br /> Date of staff site visit: Initials of site visit staff: J <br /> E <br /> m � <br /> LICENSE APPROVED BY C. DATE: 000 Z/ a <br /> r._ <br /> �� <br /> LAND SERVICES OFFICIAL z a C-7...;..' m a fel c <br /> C) i.. .-w N <br /> m <br /> m <br /> n <br /> < D= . • = <br /> Page 1of3 �,� <br /> Burnett County, WI Short-Term Rental License Application—Rev 1/2020 › 3 o <br /> x <br /> m L <br /> rn <br /> m <br />