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HomeMy WebLinkAbout040-1148-10-000 (2)St. Croix County Planning and Zoning Monday, August 2'.zoo7ats:aa:ocrM Page I of I Detail Sanitary Information Computer #: 040-1148-10-000 Sub/Plat: NA Section: 13 Parcel #: 13.28.20.276J Lot: 12 TNIRNG: T28N R19W Municipality. Tro Town of CSM: y, Vol. 05 Pg. 1311 114 1/4: NON 114 SE 114 -- - - --------- ------------- Owner: -- Reiter, Fred 348 North Cove Road Hudson, Wl 54016 State Permit: 199817 Issued: 08/23/1993 POINTS Dispersal: Non -Pressurized in -ground Permit: New County Permit: 0 Installed: 11/08/1993 POWTS Detail: Bed- Seepage Bedrooms: 4 Wl Fund: POINTS Pretreatment: NA Note As Built Plumber Other Retturements Additional Notes Money Awed Issuer/Inspect 8' x 100' bed or trench for 4 BR house $0.00 Mary Jenkins No Steiner, Paul Mary Jenkins Shied Off: Yes Maintenance Scheduled Pum Date Pumped 1 st Notification 2nd Notification 3rd Notification 101612006 10/28/2005 1118/1996 10/6/2003 10/28/2008 Lo County: V�gZn,Oj: TRO�113*28*20o576J D partment ndustry, PRIVATE SEWAGE SYSTEM Labor an4 Human Relations INSPECTION REPORT ST, CROIX Safety aind Buildings Division (ATTACH TO PERMIT} Sanitary Permit No.. R GENERAL INFORMATION 199817 City ❑ Village Town of: state Plan ID No.: Permit Holder's Name: I REITER, LEOlf FREDERIC & MARY ITROY parcel Tax No.: Insp. BM Elev.: 7 BM Description: —1148-10-000 i CST BM Elev.: 040 ELEVATION DATA A9300218 TANK INFORMATION TANK SETBACK INFORMATION PUMP SIPHON INFORMATION Manufacturer I I Demand Model Number Friction I H'eadm TDH Lift I I r%cc GPM I TDH Ft I I Forcema' in Length Dia. Dist. To Well I SOIL ABSORPTION SYSTEM No. Of Pits 7 Inside Dia. BED/TRENCH Width_ Length No. Of Trenches PIT No Of P IONS DIMEN I N DIMA!:EN51,ONS LEACHING manufacturer: SYSTEM TO P / L BLDG WELL LAKE / STREAM CHAMBER Model Number: STATION T'O N BS HI FS BS r Benchmark IL Z, Bldg. Sewer fF St / Ht Inlet 3 St / Ht Outlet L4 V Dt Inlet Dt Bottom Header / Man. ----------- - Dist. Pipe Bot. System Final Grade F � Liquid Depth 3r I Dj6k INFORMATION TYPe © 410 /� � &1� -.0 J—b " [ t,,� System: OR UNIT ........... DISTRIBUTION SYSTEM ------------------ -- x Hole Size x Hole Spacing Vent To;�i r Intake EHeader I Manifold Distribution Pipe(s) 11 1 gt Length Dia. Spacing Length Dia X Pressure Systems Only xx Mound Or At -Grade Systems Only SOIL COVER xx Seeded/ Sodded xx Mulched Mu' Depth Over xx Depth Of No Depth Over E] No EE11 Y e s El Bed /Trench Center Bed /Trench Edges ®Yes COMMENTS: (include code discrepancies, persons 1, xesent, etc.) LOCATION: TRO)y 3r 2,0 82,57" S �Z �U �Dl Plan revision required? El Yes E] . No Use other side for additional Information. SBD-671 0 (R 05/91) r. Date Inspector's Signature Cert. No. —� SANITARY PERMIT APPLICATION COUNTY L H R In accord with ILHR 83.05, is. Adm. Code st Croix STATE SANITAkRY PERMIT # —Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. El Ci ec if revision to7revious application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION T 28 N� R 20 )B�W Frc�d & Mary E�eiber NW 1/4 SE '/40 S 13 BLOCK # PROPERTY OWNER'S MAILING ADDRESS LOT # 12 ---- ---- ------- 553 County Road N CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Hudson,, WI 54016 J715 ) 386-9829 ------------- NEAREST ROAD 11. TYPE OF BUILDING: (Check one) F-1 State Owned ChNnnt Ve-%= 1, El Public 5d 1 or 2 Fam. Dwelling—# of bedrooms 4 PARCEL TAX NUMBER(S) 111111. BUILDING USE: (If building type is public, check all that apply) 040-1148-1000 1 El Apt/Condo 2 ❑Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 0 Outdoor Recreational Facility 3 ❑Campground 7 ❑ Merchandise: Sales/Repairs 11 0 Restaurant/Bar/Dining 4 F1 Church/School 8 ❑ Mobile Home Park 12 F-1 Service Station/Car Wash 5 F-1 Hotel/Motel 9 ❑ Office/Factory 13 F-1 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) 4. Reconnection of 5. ❑F1 Repair of an A) 1. [2 New 2. M Replacement 3. ❑n Replacement of Existing System System System Tank Only Existing System B) E]A Sanitary Permit was previously issued. Permit# Date Issued V. TYPE OF SYSTEM: (Check only one} Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 H Seepage Bed 21 ❑Mound 30 0 Specify Type 41 [:1Holding Tank 12 Seepage Trench 22 0In-Ground 42 1:1 Pit Privy 13 ❑Seepage Pit Pressure 43 El Vault Privy 14 El System -In -Fill V1. 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. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 857 857 7 93.15 Feet 96.60 Feein+, 1 11 CAPACITY Site V11. TANK in qallons Total # of Prefab. Con- Steel Fiber- Plastic Exper. Manufacturer's Name Concrete glass App. INFORMATION New Existing Gallons Tanks structed Tanks Tanks - - - - - - - 4-- Q 0 i-sp-r- L] 0 SeDtic Tank 00 F I r___1 I r__1 Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility -for installation of the onsite sewage System shown on the attached plans. Plumber's Name (Print): Pr bO''nat e: 9)0 mps-1 MP/1WERSKNX: Business Phone Number. Z of "5 Foul G.J. Steiner 6780 71425-554 Plumber's Address (Street, City, State, Zip Code): MR230 1ji- y 6 5; ]a i vp-r Ea I I s 54Q22 IX. COUNTY/DEPARTMENT USE ONLY is i g Agent Si n re (No tamps) F1 Disapproved Sanitary Permit Fee (includes Groundwater Datj Issuep , Surcharge Fee) .10 Approved El Owner Given Initial 7--A, 37 Adverse Determination Ord — wnm�_ 0�1 / X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: I SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. } 2. Your sanitary,permit may be ren����ed before the expiration date, and at the tirne, of renewal an new P Y �-. y criteria in the Wisconsin Administrative Code will be .applicable. 3- All revisions to this permit must b+� approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer!Renewal Fora (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax numbers of where the system is to be installed. 11. Type of building being served. Check only one and complete ## of bedrooms if 1 or 2 Family Dwelling. . Ill. Building use. If building type is Public, check all appropriate boxes that apply. W. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection or repair. V. Type of system. Check appropriate box depending on system type. V1. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with e. appropriate prefix . PP MP, etc.), address and phone number. Plumber must signapplication form. P P 9 1X. County/Department Use Only. X. County/Department Use only. Complete plans and specifications not smaller than 8'/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions y � location of holding tank(s), septic tank(s) or other treatment tanks; building severs; wells; water mains/water service: streams and lakes, pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss um performance curve, pump model and pump manufacturer; D) cross section of the soil absorption t P so pt�on system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11 /88) plot- p !on Lod \ Scalc I"= No, t r o(e Lot WooJe4 1 1pr, n I l rocs�C .1 ►u'1 ,`,J Nor�1. � Frect * AlQ r y 8ofifer L-%bn,(end )4utr;% n rl 0 1" Derision of Safety & BVildings in accord with ILHR 83-C". Us. Adm. Code Mach complete s0 plan on pap -or not less than 6 VZ x 11 inches in Ske. Plan mvS1irx;'jU6.. but __S't'Cv0ix__ pARrLL I.D. I v9dicai and horizontal ref point (W), direction and 6/4 of si. ;e, scale or not II'miled to 8 04 0-, 14 -1000 dimems'lomed, north arrow, skmd location arxJ distance to nearest road. APPLICANT 111FORMATION-PLEASE PRINT ALL INFORMATION DATE LC;CA GOV. LOT Niq 1i4 Sri, 13 T 28 IN =20 low LOT I BLOCK U00. NAI,'IE OR C-SPA J 12 - - - E - NEAREST ROAD T pnopc nTy o,,"i N c A: .red & l P�]'.tr;.r PROPERTY OWNER%S MAILING ADDRESS 553 (bunt y Pbaci N CITY, STATE ZIP CODE PHUNE NUP3ER Huc3son'r V'r 51101 6_ (715) 386-9329 p(I New ConsVuclJon U. Residental I (dumber of bedrooms Addition to existing building I I ncpfacement Public o( commercial describe.- Code derived daily Oow 600 gpd necommendc-d dersign Wding rate W. gpd/ft2 Uench, qpd!112 Absorption atea required 857 . bodo h2 750 Vench, ft2 �,Wimum design loading race bed, 9pdift2..,.�Uench, 9pdlt2 Pr..commendod inriltration surface cleval;on(s) -- 93.15 ft (as referred to site plan benchmark) Addi boial design / site considerations Use a 10' x 100' Bed -2 TSenghqs 11 x Flood plain clevalIion if applimble Parent material No PRESSURE AT -GRADE SYSTEM IN FILL WXDWG TANK S a Sullable for SySICM CONVEhqlWL 00UND 0 S D u Cs- El U 0 S El U U v unsull"ible for SYSIM 91 S 0 U M S U as ou M_ Doring X AU'A 0 ft.' J Ground 9 Depth to laclor Nonp- Boring 0 Ground elcy. 97 , 89 IL Depth 10 factor None SOIL DESCRIPTION REPOriT Flemarks: S stem flaw 4 2 Flernark-s. CST Nam@:• —Please print phone: [7151 4 2 5-554 4 Steiner Plumbinq & Electric Inc. _�__ __ Wress: CST Numboc Date: jul 22L 1993 --- 3 . 074 .__�y -.001 oring 3 Ground elcy. 96,65 Depth to rimitil factor None G ro und depth to rimlnN factor Remarks: R rn rks: Remarks: S RoI L J-k L L'i t % L Q Unbor am Hum;m fkh�rz Division Of Safety BLikfin9s in accord with ILHR 83-01Wis. Adm. Code 0-49. Plan must includ". but Attach corno.ete'she �zim on pap -or root less than 6 112 x I I inches in .-a. scale or rool,rimiled to vertical and horizontal reforance point (BM), direction and % of sl,. ej crimems'lomed, nodh artaw, and location and distance to nearest road. APPLICANT INFO R MATION-PLEASE PAINT ALL INFORMATION PROPERTY OWNER.* 'Fred & t TfJOPERTY OWNER':S MAILING ADDRESS 553 County Road N El TY, STATE ZIP COOE PHONE NUMBER Hudson, W1 54016 (715) 386-9829 r--- - st. croix, [aunt PAR: ELLD-11 — 040-1148-1000 FIE V I C.0 By DATE r,.-,oPERTY LOCATION I GOVT. LOT nj 114 SE 114-S 13 T 28 N.2 0 >6t6,-W LOT I SUB0. NAME OR CSM if 12 INWiEST ROAD. IX I New' COMVUC50n-. Use ResidenUal I Number of Wrooms Addition to existing Wilding Re acxment [ Public v commercW describe- ench* gpd/112 Accomme cd des�n Wding rale J .beds gpd/ft2..JL..V Code-'defli Ved date kw 600 gpd . 1 0 gpd . M2 . - - enchgpd42 AbsgpW area t . fired 657 . beds ft2 750 . tench, hWimum design loading rare bcd JL.�.V - ft as referred to site plan bencWark) 93,*15 pte-w=rnended WlVaUon sudau cleval','On(s) WMNWWWWWNWO� - x 5' i4iosid6onsUse a101x 100Tied nchgs Affi6wal desl5' Flood plain n ellkv', if apprienble Parent MICU AT -GRADE SYSTEM W M RXDWG TANK I& Sys lem COWD90NAL OOLIND IN.GnOUND PRESSURE 9 S G U 0S E3 U 0S Ou S a Suitable tom 91S OU IX) S, ou ou U unsolable for sn •SOIL DESCRIPTION REPORT Goring # Ground 9 IL Depth to Emoting tailor Nnnp. Goring # Grour+d elev. 97,89 IL Depth to rlmibng laciv None Remarks: P hone: CST N Print Steiner-Plumbing,& Electri- 425-5544 S 19M 3 1 V C 2�' /J � 1 d��= Dale: loo'l CST Numbof'. law 140a a r+ 010 )ring 9 . w.. u.r w• .J 3 s :f row (W.. 5 )epfh to miffing ]CIO( None Remarks: r lornng 1 D-12 .rr-- 1 OYR Z I1 None s i t 2 m if '- 12-24 _ 1 On 3 /4 None sl 1 m sbk mf ■ ' 3 2436 1 5 0YR / None 1 s 1 m sbk mf r as --- • 7 Ground erev. 4 36-46 1 OYR 6/4 None Sqr 0 - ScT ml as _- ,,.5 6- _ --- --- .7 =, 5 4 6-9 S 10YR 7/ 3 No ne s �- Depth 10 x Remarks: Boring � . _y.:: , ,..... ., 'f 0.12 _ - . .10YR 2/1 _ - None s i l 2 ;. fM 5 2 12-27 1OYR 3 4Mfr None sl 1 sbl�, 3 27-32 10YR 5/ 6 None 1s 1 m s-- sbk . Ground of cv. 4 3245 1 DYR 6/ 4 --_ None s 0 -- S9-- r Q6.1.5 __ ---- ' 7SCT 5 4 5.-1 a 1 oYR 7/3— — MI Depth to �tmi�ing - faCfotNQn Doring # 'X Ground efe . rL D,e p!h to FIMI r g facf� Remarks: STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER �%C� ..L �,�'V 7- ADDRESS,�� _3 �'6� , �%�,,� ,� �,� SUBDIVISION / CSMW LOT �� SECTION T ? N--RC W Town of Tro v ST. CROIX COUNTY, WISCONSIN Provide 2 dimensions to center of septic tank, manhole covel-- FORV N'. ';,IS.A 04 V ld Stock No. 26273 ky C E R T I F I E SURVEY I`J A P l.'JCAT'L'D IN G0Vl_:lRN%!!_Nr 1_01 3, SECTION 13, T28NO 1Z7011 LAKE ST. CRr,)!>', /A ED U _' JL C 2 -198 3 VZ23 01 oopwfu NORMAL WATFR'S EDGE 6125/8'' OL N1 Co or, Ca 0 -2 > o I _j M Ln r .1 n CO 0 LO --J CD t —J Ln C) > ro "D .n C3 Ln LA hCo CD + ZZ r'J NOTE: FOLInd Fence Post ® 1' ' rr. 2. ?j0' North of Line at this Point. r'J Lp k4-1 cc --NOTE: Found. 1" Iron > - - n (A I n . Rod 66' North of Line to ro X7 G) :3 7 at this Point. m (A kc) m — m Ul -A 0 rl 71 9 > N-1 > A C) C C •.'� I i ,� ©m° sr �. , > APIDROVED 0 A Q'..' �JOL I14 ) M83 Si. CROiX COL,.Nvy \0 `2 , Cp 4 AND lo"41N30 C014AUTTLE ASSUM,,F-D BEARING REGERENCED TO THE PLAT OF BOMAR HH EIGTS Ole '0() FIRST ADDITION. POINT OF BEGINNING instrument drafted by its ,Ties T . Swanson. )TOWN ROAD S89011013S"W Cn 1 41 7. 19' S 0'0 5 7' 0 3 E 12. 6 21 El /4 CORNER SEPTIC TANK MAINTENANCE AGREEIIENT St. Croix County OWNER./ BUYER _ ROUTE/BOX NUMBERFire Number_ _ CITY/STATE. Section T 3,9 N R,2L Ws IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERT\ NEEMENONED 0 S t Croix Co un ty of 6 Cr Lot number Lvision k, 1, T ten ance of your septic system could result in its pre uiature failure to handle wastes* Proner maintenance con sists of pumping out the septic tank every three years or sooner, if needed, by a licensed *s' tic tank M What you put into the system can affect the se 0 t ie�rseptic tank as a treat vent - stage in the waste disposal system* Croix County residents iu��L ut: St. of 60% of the cost - f replacement of a failing systems a maximum os .0 9 19780 St. Croix County 11 c- in operation Prior to July 1 requirement that whi. h was 1980, with the perly accepted this program in August Of owners of all'new stems agree to keep their system pro maIntaineds to submit to St- Croix County Zoning a, The property owner agrees d by a matey plumber v certification form, signed by the owner an d pumper verity, journeyman plumber, restricted plumber or.alicense disposal system is in proper fying that (1) the on -site was WD operat ing condition and (2) . after inspection and pumping (if nec essary) the Septic',tank is less than 1/3 full of sludge and scum. oximately 30 days prior to Certo3. fication form will be sent appr three year,expiratione ad the above requirements and agree I/wE, the undersigned have re re disposal system in accordance with to maintain the private sewag set by the Wisconsin Depart - the standards set forth, herein, as ompleted t of Natural Resources - Certification form must be c men the St. Croix County Zoning Office within 30 days and returned to expiration date of the three year ex SIGN DATE St. Croix County Zoning office 911 4th St, Hudson, W1 54016 386-4680 Sign, date and return to the above address* 0 0 • APPLICATION FOR GAHITARY PERMIT • 8TCw100 This application form is to be completed In full and signed by the ovnet(s) of the property being developeds Any Inadequacies w111 only result In delays of the permit issuance -Should this development be intended lot resale by ownac/contractor, (spec house), then a second form should be zetslned and completed when the property in gold and submitted to this office with the apptoptiate deed recording. ww.r wwwwwwww Mwwwwoo www w w wry �w rr www.rrw wwwwwrr amwMwwmGommmamr�.wwwrs ri�w++�iw wwrr asw►�www�lrrs�� Owner of property er e- and G� i. - _� V Location of property , section .. Township Melling ad dress �= ` Cis 0 Address of site Subdivision name r n M e- f Lot nuabe t Previous owner of property L e ` MEW Total size of parcels Date parcel vas created - L Are all corners and lot lines identifiable? � Yes _ No Is this property being developed tot tonal• (spec house)? Pies No Volume and Page Number an recorded with the Register of Deeds. wwwwwwwwwwtow IN" ftwwwwwww"mawfwwswwwwarwwwwrnsdaw"mwiism w®wrswoft wwwwwwwwrwrrwr�rwr.���rww� INCLUDE WITH THIB APPLICATION T112 F'OLLOWINGt A VARRAXTY DYlD vh I ch includes a DOCUMRNT NUMBIR, VOLUM& AND PACK NUMBZR, and the sm OT TNR RgGtBTBR OF DRID8. In addition, a certified survey, it available, would be helpful so as to avoid delays of the reviewing process. It the deed deacription references to a Certified 8ucvey Map, the Cettltled Survey Map shall also be required, rr.rwr,rwwMw,,wwwwwwwwwrwwwwwwwwwwwwwww40wwwwww PROPERTY OWNER CERTIFICATION I(Ye) certify that all statements on this form are true to the best of my (out) knowledge; that I (wet) am (ate) the ownet(s) of the property described In this 1nlotmation Corm, by virtue of a warrant eed recorded In the Office of the County Register of Deeds as Document No. 1 and that I (We) pttsently own the proposed alto for the sewage disposal system for I (we) have obtained an easement, to tun with the above described property, tot the consttuction of said system, and the same has been Ouly jLecotded in the office of the County Register o Reds, as Document Ho. riglilituto of owner 819natute of o-ow+ot t,If Applicable) at of gnatute Date of Signatuce F: 1 1 � �'. 1.1F• 'F', NV .-+ Il`1FN F( 14NT 1982 VA.,, RL P' f- FAR 04k_ RL Da =' QUIT CLAIM DEED A �L1�1 ' . o r]- AG_ REGISTER'S OFFICE� ST. CROIX CO., WI -. Ma.rjar.ie- H. Ahrens, a single woman Read for Record OCT 2 41989 Frederic A. Reiter and MarL. Reiter, qt:�it-ci:t:n�� t� AR Y �t 10:00 A loll _ - husband and wife Register of Deeds tilt' des.-••itwol 'real estate in 5t . Croix - .......... _.. County. RE" Part of government Lot "3" of Sect ion 13, Township 28 North, iano'e 20 West described as follows: Lot 12 of Certified Survey Map filed Judy 12, 1983 in Vol. "5", Page 1311. TOCETHER WITH and SUBJECT TO easements, reservations, Tax Parcel No: ........ .................... restrictions and rights -of -way of record, if any. -S FEffi The purpose of this deed is to convey to grantee any right, title or interest that grantor has in this property including the interest or title she acquired by virtue of an assignment of land contract recorded on April .18, 1986 in Vol. 737, Page 588 as Document Number 41211. is not F AL) AUTHENTICATION authenticated th:; day yr T ITT. H: `T 1f �. �:' T :1-�' F: I'. _1 ! ► r' �� ' . r I t `: = ' �: HEYWOOD and CART by Samuel R. Cari P.O. Box 22g, Hudson, W1 54016 August 89 41 Marjorie H. Ahrens Ai , A{}C��+.K(�NW LEDGIMENT OREGON T k T E OF 1 SS. zlrir' r Gr �3 4 rr Q •f . YU Nt;3 Oregon r•., ,,,►. [",x -IT '': V-1 r`o� D