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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI i4 r- <br /> c (D r <br /> ` <br /> Applicant_Com lete AllSections Below This 'ne / G v <br /> Original License Fee $300 .� Renewa License Fee(Ann ally) =$150 is. 7 co <br /> �. <br /> Property Owner's Name: h e r114.ci.t <br /> 11 �C r Y` 7 ©y1 C�[✓ol e L S®Yl <br /> ar/o. C.e a(S©sirI r ( ' c :? <br /> Property Owner's Mailing Address: / a 4;1,L,fit /1Us > ? v� <br /> R City State Zip <br /> 70 <br /> Property Site Address: a .. 1, OfcQ t— Ke d c N <br /> We.1+e4A, i7 sq F?3 N W <br /> Applicant's Telephone Number: (14J) 7'23'-a 10 0 o ' <br /> 0.1 <br /> Applicant's Email: 6. <br /> L( L'plc. (zCc „ n e 4- n <br /> **If staff has a question about th pplication,you will be contacted via email. Make sure your email address is 0 <br /> legible and your email provider will accept emails from the following addresses:@BurnettCounty.org and <br /> (c4BumcttCountyWl.gov �t nJ �^' r-. r <br /> Legal Description of Property: p,5" Oc 7-3,F 4 R iJ � �-'�-^ o `+ <br /> Section#: 6 Town#: 3 D N Range#: /5- W Town of: L, A F9/-LLe / / E <br /> c <br /> � w <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): g!!/ omo <br /> • <br /> Provide Rental Information N �' <br /> �n <br /> 1 . <br /> License Year Applied For: a20623 Amount of Renters Applied For: Q Cl , S <br /> Local Contact's Name: BY�' ©i5o11 07 <br /> z 1 <br /> Local Contact's Address: (21 7 3 C '1 Yi ` y Pi J Pl,,',`'e, biz-s 9 <br /> Local Contact's Telephone Number: &isj 2. - 6 053 Ciry itod.0'i „„ 0.0 R <br /> W <br /> .TA EJ Most Recent Burnett County License Number: STR- State License Number: „ -C jr_ F <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY il <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> -L i a-nst .ex e►aS '1st )2tty ( > ;l i .z-,o44-= EA--GeS g 1914 �' ' ' <br /> al <br /> a -tui OJ\j a�c�vur ' -1- n4 4° - tc-ilA d (� e It Q-e-r z <br /> SQ.r-I-c,r4 ,rmi-l- " 32 3$3 <br /> 1 <br /> -C�,rrktk ' uAd�,U+�,S -Ib bt ro A r - ry�p;,��tvi4 w X d _ <br /> m Fee Rec:S <br /> ` I 1 I2o2. (t& (� q II nos r vo <br /> -VOINQ ct, I Li(eitEin �n <br /> I� ri <br /> rti <br /> cn <br /> Date of staff site visit: 6 123 ion Ini 'als of site isit staff: o <br /> LICENSE APPROVED BY DATE: I.P / Jzoi3 <br /> r 0 m, 'nry' <br /> LAND SERVICES OFFICIAL n cu U u U <br /> $' a 0 (xi <br /> et 0 0 <br /> Page 1of3 d -"< N <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2022 › CD ``' <br /> x w <br /> MS <br />