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6 H0kT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI r <br /> Applicant Complete All Sections Below This Line N p <br /> Ori C <br /> iginal License Fee= $300 Renewal License Fee (Annually)_ $150 <br /> d � <br /> Pfoperty Owner's Name: <br /> Property Owner's Mailing Address:A 10 fi?,17/ <br /> City '1 State Zip <br /> Property Site Address:? /IZ�f T{�l2 .� y �J3Morr11:1.5w� � o <br /> Applicant's Telephone Number: <br /> CD <br /> Applicant's Email: 114 <br /> { N <br /> **If staff has a question about this application,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: @BumettCounty.org and <br /> @BumettCountyWI.gov <br /> Legal Description of Property: <br /> 1_C) l� C_S 3� `t v0 jC) d <br /> cection#: 31,0 To:vn#: / 0 N R.ige#• l.'� W Town of: j o��►l SO✓� � � �.. <br /> *Attach additional a e i needed or lengthy description OR attach a co o the deed OR attach tax system property page.** UQ <br /> P S .I� .f S Y P / �� PY .f Y P P tYP g <br /> Tax ID#(1-5 digit number;found on tax statement): l l� �� A <br /> 0 <br /> Provide Rental Information <br /> License Year Applied For: Amount of Renters Applied For: <br /> l,, <br /> Local Contact's Name: n G Lek 1 rv)�c4Le— ro <br /> ac <br /> ,/� o <br /> Local Contact's Address: G ��< �� ���� 1/r a �� �;/ �(. yG�v <br /> City State Zip z <br /> Local Contact's Telephone Number: 7/5 33 -"1`127 <br /> Most Recent Burnett County License Number: STR- 2 —IR4 State License Number: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY S <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ° <br /> � LiC2vtse� �P►��s t -31-202�. � a <br /> �`J OCCupa.v� 4 a,du� bSew�e� Nt+ 1-0 4xceed (o ues+s i� o <br /> � 9 <br /> Per ,In-2O-q(.0 <br /> V m Fee Rec: <br /> oCk#: <br /> Lh <br /> a <br /> n <br /> Date of staff site visit: �Z3 Initials of site visit staf : I o a D <br /> ' z CO M <br /> LICENSE APPROVED BY vV <br /> -DATE:— ev <br /> LAND SERVICES OFFICIAL <br /> Page 1 of 3 w <br /> Burnett County,WI Short-Term Rental License Application—Rev 12/2022 <br /> x <br /> a <br /> m <br />