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C r <br /> cr <br /> E3 r. <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI I: <br /> Applicant Complete All Sections Below This Line n. <br /> d : <br /> w• ,B <br /> Original License Fee= $300 Renewal License Fee(Annually) =615 <br /> g <br /> Property Owner's Name: del/I J.e.ytt.ei W y <br /> U 'A , <br /> Property Owner's Mailing Address: '0 a ,. ac 4V 4-.1", <br /> 1 , 1 S al K..Mcc to( 94 ' < N N <br /> City StateWT2ip o ' <br /> Property Site Address:a1( bro7ii , QO A GI 'DQy(b J W� 942 d r <br /> G <br /> Applicant's Telephone Number: 116 - 91-as - o'jg5 01 m o <br /> Applicant's Email: ‘1J1,ndov�s CUS D V1u►hornts c- I•Cori ~ CD <br /> J r �YY1 •i <br /> . <br /> Legal Description of Property: carCe1 OF land 'OC�In o pn iV1�l.G(/l.'- \o d3. d <br /> a, , <br /> Section#: Cl Town#: 4-0 N Range#: t 4- W Town of: u Sc- ft ,,.,.. <br /> o N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* a <br /> Tax ID#(1-5 digit number;found on tax statement): 11-$t T 4. 4 W <br /> cci <br /> 0 <br /> Provide Rental Information ci, 0 <br /> 0 <br /> License Year Applied For: �,O a-+ Amount of Renters Applied For: 3 <br /> (t <br /> Local Contact's Name: C, c cO1pi,1ri p-y-) I <br /> � z <br /> Local Contact's Address: ai�q I Le 51,► lore.,Uin Q, Zr. WelcioLaJ,Le. WT. 94-?30 ° <br /> City State Zip <br /> Local Contact's Telephone Number: -11S - D,6 al ---n (3 , <br /> Most Recent Burnett County License Number: STR- o� I -1 D State License Number: tr*Q\A—612.9 L.3 C 0 <br /> .0 U d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: • g v <br /> As pec- ;\ k . Li \o ca` co(\kaCV NA r11e. - phone rlomhcr .. 11) °P <br /> Musk \c' 9osA e� z. o v <br /> -T <br /> Ma1�1n�0rn MAb0nfi 0-c roA�C 'S ‘t 5 t t caplet tAclu3;nQ ch,\c\c n. k <br /> J s <br /> 1'o\\ow k\\ \;cc'5e. Cc.qu;f e me,nks . ., <br /> 1� x <br /> dFee Rec:/56' <br /> 8 Ck#: .70b1 <br /> ri <br /> Date of staff site visit: 1 - 2-g - 2-Z. Initials of site visit staff: K L_ <br /> n <br /> LICENSE APPROVED BY at h <br /> ,et4.. . DATE: 1 -.3 I ZZ. fill <br /> LAND SERVICES OFFICIAL "a,I <br /> D o Jr; o <br /> Page l of 3 , <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2021 11gill <br /> LL J <br />