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. t--. I.. <br /> CI <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI J: g g <br /> Applicant Complete All Sections Below This Line 2.--,_ C <br /> E <br /> Original License Fee = 300 Renewal License Fee (Annually) ($150 �,, A <br /> Property Owner's Name: et Li i d A,G "er N V <br /> ►-3 <br /> c-4 <br /> Property Owner's Mailing Address: 1 0 0/ - N t� <br /> Property Site Address:2 7.� < g X),eliz- Ao j, ��, Y3/ r <br /> State te�5Z;ipu,� <br /> ,:- <br /> r ' 1 <br /> //,,� �72//9?-- <br /> / uv tf�f ri V�' <br /> Applicant's Telephone Number: bIa2 < --2/ 9 ._ o <br /> Applicant's Email: 3 2—m qer-ly a p ad i eofi9 -. . <br /> ' <br /> Legal Description of Property-'/ / 7 t'/heC'N 54 of- 1''4/ Z 4/ '' 47$/p. 1/=/L8//C/ v t• <br /> Section#: .3 /664-)Town#: A10� N Range#: /(2W Town of: .a, X/ail CD`� (3-- <br /> *Attach additional page if needed for lengthy description OR attach a copy'pfft e deed OR attach tax system property page.* oc _ rl <br /> I,`f /) C7 n N n <br /> Tax ID#(1-5 digit number;found on tax statement): 3 < W g <br /> 0 <br /> Provide Rental Information 71 c <br /> fi S 7(' i •►� <br /> License Year Applied For: Amount of Renters Applied For: q �S� ,.. <br /> Local Contact's Name: g I L 4- C% 6 2Orgesv )1 , <br /> 07 <br /> Local Contact's Address:g O?5 St›Aiks'i Zttf`G- A tdi-e v"f' 5`1 9 <br /> rDo, City State Zip S c. <br /> Local Contact's Telephone Number: 61,) -S' 75----/ e at` <br /> v, 61 <br /> Most Recent Burnett County License Number: STR-?/ -17a2 State License Number:iC lig_4b/2,J63 s <br /> t. <br /> x <br /> Ei <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: '-3 W <br /> ' L; cense, exQ,ce5- \- 3\- 23 o o •c <br /> 0cco, ,ac\c� Van-dr g Qe,o1c,, incl� c�.n ch��dcen <br /> pro bc, o si.ec� ?Crt CM t' 1- • --- <br /> Z — <br /> �v,be\,nes p Q X Q <br /> 15- <br /> Ei,c <br /> oFee Rec:150 <br /> Z Ck#: L5Clg <br /> v <br /> Date of staff site visit: 3 - 1 - 22- Initials of site visit staff: t4 L < <br /> n <br /> � <br /> L 3 . 2 _ ZIDLICENSE APPROVED BY .l%?/L1J�/�,,,� A. A.A. DATE: , <br /> LAND SERVICES OFFICIAL aL11511 <br /> cn co II'Wny0u"o' vo0Page l of 3 - QBurnett County, WI Short-Term Rental License Application—Rev 12/2021 - m �' <br /> m <br />