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A. <br /> SNORT-TERM RENTAL LICENSE APPLICATION - Burnett County, WI r <br /> Applicant Complete All Sections Below This Line 9 5 p <br /> c <br /> L OriOnal License Fee=$300 Renewal License Fee(Annually)= 150 a <br /> d <br /> Property Owner's Name: c CQ� <br /> Property Owner's Mailing Address: C�IC � \�A5v�ex� `i1 <br /> ��, wq•5�,1 S � t.JQ•r1 City Z <br /> lJ�� 1p <br /> Property Site Address: o <br /> � N <br /> CoS\ -Applicant's Telephone Number: G--5- _740 o <br /> Applicant's Email: 2_o cc C6�(Y'1 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is x <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov <br /> Legal Description of Property: i � <br /> Section#: ZZ Town#: N Range#: W Town of: �� N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o - <br /> rova <br /> Tax ID#(1-5 digit number;found on tax statement): � �L+ d o <br /> Q � N <br /> A C <br /> Provide Rental Information <br /> License Year Applied For: �Ao g�-�L Amount of Renters Applied For: co � <br /> Local Contact's Name: it cca rcr! <br /> 3qO`l (o1�0 CAP <br /> L w� <br /> Local Contact's Address: kb+ Ic o <br /> City State Zip <br /> Local Contact's Telephone Number: �- <br /> EZ <br /> Most Recent Burnett County License Number: STR- 23 (P 0 State License Number: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o Cfl <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> � o <br /> O LlCer �Y res l"31-202(0. u <br /> 2 bG c Sewer• 0 rlu.mbP,+- r� o z s <br /> is OCa ii <br /> ��ceed•Sa��e. C.cS�,da.-h anS. � i•1 v► <br /> m <br /> - <br /> O Fee Rec: <br /> 1 ceKe,*l Cbfret+ Local Cv1 Lf"A avid Vu nbw anA = Ck#: 6 Ir7/ <br /> �YreG�- �Sfa�� 1 iC n c�w►be� loy q-30-Zo25-. m <br /> Date of staff site visit: ` —ZS Initials of site visit staff: T-T+`"a <br /> LICENSE APPROVED BY � DATE: <br /> LAND SERVICES OFFICIAL m <br /> cm <br /> v � cm <br /> Page 1 of 3 <br /> Burnett County,WI Short-Term Rental License Application— Rev 11/2024 (� <br />