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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI � r <br /> & W. <br /> a C n <br /> Applicant Complete All Sections Below This Line `-� C y <br /> 0 Original License Fee= $300 It Renewal License Fee (Annually) _ $150 a <br /> d � <br /> Property Owner's Name: NoaVavOAm 56&s <br /> Property Owner's Mailing Address: vay, BMW & N H o �k�s MN 13y3 � y <br /> City hState Zip� <br /> Property Site Address: Jdl YV l{ o <br /> PP p 3-221�[�0 7 0 <br /> Applicant's Telephone Number: <br /> CD <br /> Applicant's Email: A0 SG(OI.S all'awl <br /> **If staff has a question about this applica ' n,you will be contacted via email. Make sure your email address is o <br /> legible and your email provider will accept e ails,f}�om the followi g address: @BurnettCou)ntyWI.govCD <br /> �Pt 13 Of CTA yJr I I nQ 1622- 5 rL� , <br /> Legal Description of Property. o$i-CI d� ��'2"2`y0-I `� 05-00 -bl5 <br /> I/ s M d <br /> Section#: 22 Town#: �N Range#: W Town of:,j�5(7n N <br /> 0 <br /> *Attach additional page ifneeded for length},description OR ottach a copy cf!he deed OR attach tax system prvpertj page." rs -� <br /> 0 o <br /> Tax ID#(1-5 digit number; found on tax statement): <br /> � <br /> � C <br /> Provide Rental Information ° <br /> License Year Applied For: -V � Amount of Renters Applied For: <br /> Local Contact's Name: LV\ <br /> Local Contact's Address: r�� r W ( <br /> G C' State Zip -� <br /> Local Contact's Telephone Number: 7l�S'33 - D (']J- t1t7CP_ 1 qq2 <br /> q..5 h <br /> Most Recent Burnett County License Number: STR State License Number: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY c d <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> S � <br /> C> oQ <br /> Z OCCuQQiMi R� a� w S� a1ierY� {�c�-�fl �e�cC��d `-E ��i� fee- 0 z <br /> 3 � tr <br /> (aCval a,v� ��,,�. �.�d�.���s -m be.��c�ated <br /> j)tlur�lW C�Vuk �Cs� (;t,t,t�rC✓lf" Cvi,cntti� l-tCE� V�u6v,la2r b� a FeeR,: - <br /> Ll� ro Ck#tQ9 <br /> Date of staff site visit: ,13 20 2-5- Initials of site visit staff: ` 16 -- <br /> Q <br /> LICENSE APPROVED BY 2 DATE: ' � � m g C�1 <br /> LAND SERVICES OFFICIAL o o <br /> a <br /> Page 1 of 3CD <br /> C <br /> Burnett County,WI Short-Term Rental License Application—Rev 11/2024 <br />