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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI c r r• <br /> f, r. <br /> a a A <br /> et <br /> Applicant Complete All Sections Below This Line y. <br /> Original License Fee=$300 Renewal License Fee (Annually) =$150 a <br /> �j�J �� d <br /> Property Owner's Name: /"l,6 C Ft G�f/Li�<t(� t U � - <br /> Ajet" <br /> R's <br /> Property Owner's Mailing Address: /I 3 t C e(t �r.t.::. 0.... c ) i yoi 7 <br /> City State Zip <br /> Property Site Address: C 3 `' ' �� rG (-e Ili (Ah9 d W. 0 y � o re/ 3 Q o c ?' <br /> A <br /> Applicant's Telephone Number: 7i S 76a _155 o <br /> Fi <br /> Applicant's Email: 4-!a+'',A, 0 c 1'1 4-r-`4 ,e se cf..4 v zs j f. o-GA4,0—cl L. rp <br /> **If staff has a question about this application,you will be contacted vial Make sure your email address is rri 0 <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 2. <br /> TOW ill G f 0 ut k (CA AI ZAk.e A©Legal Description of Property: +t71',-- ir <br /> 5 • <br /> Section#: 2- Town#: 11.0 N Range#: /6 W Town of: OA—kV.A.., 5.. , <br /> a <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): /2 g,S3 P n c I. <br /> `E N <br /> lJi <br /> a <br /> Provide Rental Information 0_____I___? <br /> U R <br /> License Year Applied For: 2 0 Z 1 Amount of Renters Applied For: 1�Ty"� a <br /> n� (� l <br /> Local Contact's Name: ' tC--Cs7RA L lr 6..,./�0 et> �(� <br /> T Q,rt,ry�y & S ,, <br /> Local Contact's Address: f i V ` o <br /> 2219 2866 Ave C 'inc), City State Zip e N <br /> Local Contact's Telephone Number: 116-Sla(p -OTC19 0 O <br /> Most Recent Burnett County License Number: STR- 23-31 State License Number:NW O .-CD KTrv1Z ° a, J <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ) o N x <br /> o N o <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: < -3 o N <br /> 0 LiCQ nse �X (es ‘it 12026 y c <br /> �I <br /> ( .0e-ii,C. •--c,.✓1 . .Id �o k Sapfed -� A IOCk. otC/1 Gilct,rV1 l l 12°2-11 <br /> ! z <br /> DCL PAW aid adkver-h-e rrin.+ to-i -b i% d li) rttr[-e- n po <br /> P-- <br /> uP <br /> rn <br /> atteCIA4 <br /> 1 ,' � I ^, I ^ �� c�rtn4-ai 5u,1 dtb al% LOC.Gil c 0 Gl(+ cncil Fee Rec:/ <br /> Ck#: 1"3 a 97 <br /> Cak114-9 11CUp. V\vombe.-r- rn <br /> M l <br /> U <br /> Date of staff site visit: 1 Ii zozq I itials of site visit staff:t L I 4-6L <br /> su <br /> . . <br /> �/LICENSE APPROVED BY . DATE: ( 0�/zz4' Q. .— <br /> Q F =s <br /> LAND SERVICES OFFICIAL Fr,''m re, 1Ins, <br /> 0 o =1 <br /> roc N <br /> Page l of 3 ° F3 , <br /> Burnett County, WI Short-Term Rental License Application—Rev 12/2023 2 riffl <br />