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� r t•" <br /> c <br /> 0. <br /> SHORT-TERM RENTAL LICENSE APPLICATION— Burnett County, WI <br /> y <br /> O C <br /> Applicant Complete All Sections Below This Line 3 $ C <br /> d � <br /> Orittinal License Fee = $300 Renewal License Fee (Annually) = $150 <br /> Property Owner's Name: (AZfbe,4- L A L D /Jy g e,� T / ea <br /> Pa- <br /> p <br /> r JV1 p .may y <br /> 0 <br /> Property Owner's Mailing Address: 21 " aKW n Ave Hpu 65435 <br /> ii City State Zip o <br /> Property Site Address: Z 7 1536 H t t l �.o ad S po©oe y-, W t 5 T�L s t � <br /> n G q q A, \ <br /> Applicant's Telephone Number: (0 t "�" - 6 1 (AWd fee_ J X <br /> Applicant's Email: QW1 por r i sk COMG6Z�:�- <br /> ' <br /> o w RD pLo 5akA 'L Z,03 !►Y ` y1t ( oLegal Description of Pro rh. OVa (p-IVYS. D-! Otl <br /> Section#: (p Town#: 1�N Range#:_i.�(- W Town of: <br /> *.4ttach additional page if needed for lengthy description OR attach a copy oj'the deed OR attach tax system property page.* voo <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> 0 <br /> Provide Rental Information <br /> License Year Applied For: q 7) Amount of/Renters Applied For:�^i�P , <br /> Local Contact's Name: N l C.(K 0'r w (/�fir L o Y Q l'1 eVl T (JL 1 C d.) IQ <br /> ro <br /> Local Contact's Address:101 1 8 u r o s Par K P r• y e l l (a-K e, Vv j �•-T 7 1 _ ° � <br /> _ QQ City State Zip ` <br /> Local Contact's Telephone Number: (015 i � - 35 U N <br /> kW- -0315q N <br /> Most Recent Burnett County License Number: ST - State License Number: -- W <br /> It <br /> � d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> L.to-W99- <br /> OCCUCO IC� C�tr -t-D -e,�CCeed l� ople,re z 4;- <br /> (� PO 0"Stft e +& tD be, 0 P 6&-WA td Ca Teft- ALL W be o-� <br /> Fevr skn*F 19 20 2 b� 7-3o-2(n. <br /> tD be b0t&de� neon- � 0"A .R. r&0(4 door <br /> 1�.2��Q-1 9 U,l d211 iv►e5 � - Fee Rec3mp <br /> by 7-3o-Zfo See L64-P, Lt, b� Ircewt r,5 rec��elnt5• o <br /> Date of staff site visit:? �Z3 Initials of site visit staff:'k T Il2u1 GGWCJtCn <br /> - dam, <br /> LICENSE APPROVED BY DATE: 5-2 -',Q 2-5- <br /> r <br /> LAND SERVICES OFFICIAL ? a <br /> 3 <br /> cn <br /> m 02 <br /> M — IV <br /> d p C oa o <br /> Page 1 of 3Wz <br /> CA <br /> -, N <br /> Burnett County,WI Short-Term Rental License Application- Rev-4Q948 <br /> zap m CD M <br /> C7 <br />