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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title page <br /> Owner's name: ,/ r m Tor k- <br /> Owner's address: Z`966-6 ULent�t/ wet, <br /> ,QaNbwy ti.J� S4�j30 <br /> Site Address: ZC(3rj�j �.J'/� JUrNs / NC�j <br /> Legal Description: �{GTkS <br /> 0 ie� w z <br /> 69/vU lob-.5 <br /> Town: TaC145 /Jj/' <br /> County: �v JrW4T " <br /> Subdivision Name: Lot No. Block No. <br /> Parcel Identification Number: Q1 Z470/084(0D <br /> Page lndex <br /> Page 1 Index and Title <br /> Page 2 Plot Plan (May include septic tank and filter specs) <br /> Page 3 Distribution Cell(s)Cross Section <br /> Page 4 Maintenance,Management and Contingency Plans <br /> Plumber Name: �!S !© 9�if� Credential No. SS��IS <br /> Plumber Address: Z 7,77c 54-,w/n j ,,&Q_/p <br /> Signature: !� <br /> Date: 9 S�Z Phone No. 715-40446-bQYX <br /> Designed Pursuant to the: <br /> In-ground Soil Absorption Manual for POWTS Version 2.0 SBD-10705-P(N.01/0 1) <br /> Page 1 of_ <br />