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Home My WebLink About010-941-31-4415-LUP-1992-406 Application for Land Use Permit � � County of Sawyer o The undersigned hereby makes application for a Land Use Permit and � � agrees that 311 work shall be done in compliance with the require- o ments of the Sawyer County Zoning Ordinance and the laws and regu- M la-tions of the State of Wisconsin. f PRINT - USE ELACK INK OR PENCIL dba Cameron's Coffee Co, Inc � D James H. Cameron )J�YY�� Con��t�u��l,� .b Owner � Bui der �6 ��-Z -3 � P.c. sox 627 0� IDZ Mailing Address Mailing Address � \`��.�� w�. s�g�F3 s�.P�\ �� 1,- . S�{�� I City, State, Zip City, SCate, Zip Building Land Use Zone District �- � t" g ( ) New ( ) Filling -. � � � d � Addition O Dredging Lot size _ �f�� bQ0 m r�t ( ) Alteration ( ) Grading � ( ) Moving On ( ) Acres 3,gQ ��ppra� ' � ( ) ( ) New Construction k, - • J Size SC� ft wide ft wide � 100 ft long ft long � FLoor area �pp� sq ft sq ft � � � Total htg Z7j to peak to peak � � Stories � Stories No. of Bedrooms reaz- Yot- Iine or waterlirie c� � o (year round) or (seasonal) � $�;U' �, rt Type of B1dg or Addition 1 .� � � r� ( ) Dwelling ' - �'' ° ( ) Garage (1) (2) car �. � F � c rt , �. (� Storage Building � �a_ J- v, ( ) Boathouse r� s. �' ( ) Livingroom � � � ( ) Bedroom p ( ) Kitchen-Dining � �, � °� o � ( ) Porch - enclosed/roofed � ' � � � \( `) Dec`k - o.pen ' fC,n 4� r�' y4'�f00.�c�.o� �fi� Y f w r\ ( ) L 4 � � ,oe- g � Type of Construction `r'• i v z ,� ( ) Frame ( ) Block � i � � o� ' o w ( ) Log ( ) Concrete � � � � Po1e ( ) Steel � �a,L -- -.- $- - -�. Metal ( ) � N- � � � � o Construction Cost $ �QOippO.00 � 1- � , �,,) 3l b 3a �Y ,� I,,., Vol oo Pg gi, of deed � o I w CS Vol � Pg �" I J � °� W ,d � �- o n Ger. Soil Test 92-118 � � � m � Sanitary Permit;<.=92-082 ----------E�ad-4��-----`�----- ~ z 0 • z z Issued 2��'�p� (QqZ Denied � � � �N - , n� -cD�]C" £ Owner 'Loning Adminis rat r i , .10.1 .9.1 .141 .13.1 ,I6.9 � ' � 12.2 .IL.4 , I I � .16.7 .15.I � ' i 4 .15.2 .16,2 12 3 .I I. I � �63 .12.1 �, 63�� .15.4 G�S'N' .16.5 .12.4 .16.8 .16.1 .I 1.2 .15.6 123 .15.5 .15.3 .I 1.3 .12. � . .16.6 - NOT USED SCALE: I INCH= 400 FEET FOR ASSESSMENT USE ONLY NO DRAWN BY: S.RD. DATE : 4/l0/64 INTENDED TO SHOW CONCLUSIV COLON (:) INDIGATES GOVT. LOT EVIDENCE OF OWNERSHIP OR BOUNDARY LOCATIONS � DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis. Adm. Code couNry — ' Saw er CST 92-118 STATESANITARYPERMIT# —Attach complete plans(to the county copy only)for the system,on paper not less than 164339 8'r4 x 11 inches in size. ❑ Check if revision to previous apptication �ee reverse side for instructions for completing this application. s7niE P�nN i.o.NuntaER I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. SC? — pL�(o PROPERTY OWNER PROPERTV LOCATION James . Cameron 6 �C%7� ci . '/a�/a, S T , N, R E (or) W r�� . � PROPERN OWNER'S MAILING ADDRESS LOT# BLOCK# � CI7Y,,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBEF �,er �Y II. TYPE OF BUILDING: Check one Ciry C�� NEARESCROADL�U �j ( 1 ❑ State Owned VILLAGE ' 1 l� J Public ❑1 or 2 Fam. Dwellin�#of bedrooms— n cE�rqxNUMeER(s) III. BUILDING USE: (If building type is public,check all that apply) O 10-9 41-31-4 409 1 ❑ ApUCondo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestauranUBar/Dining 4 ❑ Church/School 8 � Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 � Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check IineB if applicable) A) 1. ❑ New 2.�Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.❑ Repair of an System System Tank On�y Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit# — Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 �SeepageBed 21 ❑ Mound 30 ❑ SpecifyType 41 ❑ HoldingTank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ PitPrivy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED(sq.k.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) EL�EjVATION �y`�b �� G G O � ,�3 Feet /-3 Feet VII. TANK CAPACITY . � Site in allons Total #of Manufacturer'sName Prefab. Con- Steel Fiber- plastic Exper. INFORMATION New xistin Gallons Tanks oncrete structed glass App. Tanks Tanks Se ticTankorHoldin Tank �s Litt Pum TanWSi hon Chamber VIII. RESPONSIBILITYSTATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name(Prin[): Plumber's Signature:(No S �mps) MP/AhPR61'fHo.: Business Phone Number: � -� �Z` � �� P mber'sACdress(Str e,Ciry State,ZipCode�:� � ��s c/ �i /" (.�Y-- IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sani[aryPermitFee (IncludesGrounawater ate ssue Iss ingAgentSignalur (NoStamps) {� Surcharge Fee) yy�Approved ❑ OwnerGivenlnitial $11>r . 00 6-4-92 Adverse Determinalion X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly PIb�7)(R.11/88) DISTRIBUTION: Original to Counry,One Copy To:Safery 8 Builtlings Division,Owner,Plumber CR!{E{�ON CoFF6E PcZ—r SE— SE 31. 41 .4 . 16.9 ' �. �H FoUNOATtON RT-GRA-O� I00� � �0 26 o PERc „ i ��,e- f - 40 s�sr�, r-c�1. 973 �x��PT w+�E�. r•IoTED � � �✓} "p `Ti(1G+�? /C �'�"' 7 2�"� � f'y�'l/2c� �d �� I� ►� 6 - z-9z iii 2� I ► ► � �� I J � � � ► I I � I ' I � � g�IS�M I P� ��\�4y �� Ng\'!�`�'� , . oh ¢ v� �/ ��Z`pN —o \'�j° �-p� ��,�P �' S" � �gpF PNg�p\NGS � V. �"� pF 1ydU .S�FE�� pNp DEPPRS�'`r1p�V�5�GN . �y PEgPoN��Nc� sE" .>. ' �c� , ,��6.�� 3 �� CST � 34 c e , � 3 �" S�� . /00 x 3S,r- �/ _ /Sc� � �� .�s�� .�ao � �� S 9 2 � 2 0 4 � � ��-�� irr.s� .s. ,; .. ._..�..... �,._:�.M. :._4,__.. . _ ,.,__�__ ..t_ .:. .� , r .,._R�.._....,..,._..,,;�._, ��:.�...� . .. . ' . . . . . . ' . � . . � f <! - � � � SAFETY& BUILDINGS DIVISION l ' 2226 Rose Street LaCrosse , WI 54603 State of Wisconsin Department of Industry, Labor and Human Relations September 2 , 1992 THE STUBENRAUCH ASSOCIATES , INC . CAMERON COFFEE CO INC WILLIAM TURNER . JIM CAMERON P .O . BOX 267 , 315 W. FIFTH ST . HWY 63 S HAYWARD WI 54843 ' HAYWARD WI 54843 RE : WAREHOUSE/FACTORY CAMERON COFFEE CO INC HWY 63 S HAYWARD County of SAWYER Plan Number 92-08-1166-B File Number E-002247 Volume : 5 , 000 cubic feet Suprv . Professional , Building : WILLIAM TURNER Suprv . Professional , HVAC : WILLIAM TURNER Your Building and HVAC addition plans have been conditionally approved . The above-referenced plans have been stamped CONDITIONALLY APPROVED based upon review for conformance to the current edition of the Wisconsin Administrative Building and Heating , Ventilating and Air Conditioning Code , chapters ILHR 50-64 . The plans have NOT been reviewed for conformance to the �lumbing Code (chs . ILHR 81 -86 ) , the Electrical Code (ch . ILHR 16) and any other ILHR code not specifically mentioned . Subject to local regulations , construction may proceed except for those conditions listed below . The necessary corrections must be made before construction begins . The owner , as defined in chapter 101 . 01 (2 ) (e) , Wisconsin Statutes , is responsible for compliance with all code requirements . The owner shall notify the state building inspector and local officials before taking possession of the building . The building will be inspected during and after construction . ILHR 50 . 15 EVIDENCE OF APPROVAL . The architect , professional engineer , designer , builder or owner shall keep one set of plans bearing the appropriate stamp of approval at the building site . Prior to installation , truss plans and calculations shall be submitted to .. . . � _ , . ,>_ _ >_ _ _ _ --- - _ -- - - - ____ _ _ �,- _ � � ,:�� . _,. ' � SAFETY&BUILDINGS DIVISION � State of Wisconsin Department of Industry, Labor and Human Relations THE STUBENRAUCH ASSOCIATES, INC. � September 2, 1992 Page 2 this office for approval . ILHR 52.04 This plan has not been reviewed for the accessibility requirements of the Americans With Disability Act and Federal Fair Housing. Presently, these requirements have not been incorporated into the Wisconsin Commercial Code. These rules are administered by the U.S. Department of Justice (1-800-USA-ABLE) and HUD (414-297-3136). ILHR 52.04 (3)(a) The plans do not indicate that adequate accessible parking spaces have been provided. Spaces are required to be properly marked and located as close as possible to an accessible building entrance. ILHR 52.04 (8)(d) 4. b. Grab bars are required behind as well as alongside the water closet. ILHR 52.04 (8)(a) Accessible toilet rooms; sized and equipped for the physically disable, are required. ILHR 52.57 The floor and base materials used in the toilet rooms are required to be waterproof. ILHR 52.58 (1) From the information provided, it cannot be verified that the material specified for the toilet room ceiling is smooth and nonabsorbent, as required by the referenced code section. This building is classified as No. 8, wood frame construction. Sincerely, �,�;�� Chris Luster Building Construction Inspector II (715) 442-3800 CLL:vs: 1128 cc: State Building Inspector: R-4 Black (715) 634-4870 Fridays Building Inspector, HAYWARD SBD&12�iR01/U1�