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C C <br /> n ..a a o n <br /> SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI I: ° a <br /> c eB <br /> Applicant Complete All Sections Below This Line a C <br /> d g <br /> Original License Fee= $300 Renewal License Fee (Annually) =$150 v. _ 21 <br /> Property Owner's Name: r'+C%u,.,✓t a 4,- c-&--. <br /> Property Owner's Mailing Address: / N <br /> State <br /> Property Site Address: c /7c A.--,41,...„ s j 2i b S-'' , Citytu x �yrio r a' <br /> /' ��__// a <br /> Applicant's Telephone Number: £ �,,1- <�(c'C' 'CV$7 a o <br /> f <br /> Applicant's Email: Ger- C,-f et &tS 1,9/4,-e..,,,,/ .e c►-� P. '' <br /> g. <br /> Legal Description of Property: 5.-e e4 d a <br /> Section#: Town#: N Range#: W Town of: o��' .. <br /> 111 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o0a ' <br /> d C 0 II <br /> Tax ID#(1-5 digit number;found on tax statement): 5. E W <br /> o <br /> Provide Rental Information w <br /> 0. <br /> License Year Applied For: Amount of Renters Applied For: 41 (� 1 <br /> Local Contact's Name: t'1.0.-In-)V%. "e(iti 0 <br /> z <br /> Local Contact's Address: > .---/c C'e'p JL s' 14.t.,/ o <br /> City / State Zip <br /> Local Contact's Telephone Number: Cl al- )60 -0/c- > <br /> Most Recent Burnett County License Number: STR- State License Number:4 +,L31''^�f <br /> ✓"` -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY e_ <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 0 <br /> ,� <br /> iL f Ckeoil IS neeeid oar B41 a. <br /> irY1-eA4tr L i%5 neec.W Li cc051 % d*kcIx <br /> 7 <br /> a <br /> oFee Rec 00 _ <br /> o Clc#:ro <br /> �,�L21� <br /> �f /2 � <br /> Date of staff site visit: l�I71 O Initials of site visit staff: (� < <br /> a <br /> LICENSE APPROVED BY : A /v/.‘,....----- <br /> �- DATE: q /a' m r- <br /> LAND SERVICES OFFICIAL / o n <br /> a r <br /> n . m <br /> n t�9 C <br /> Page l of 3 a °' ^;C <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2021 1 G1 <br /> m <br /> m <br />