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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: . /n 51% FFA/ <br /> Owner's Address: rry j=p r/11 S <br /> iNA a A) S`5- 3 <br /> Site Address: JrY S - h ,2 -0 /$ Lk AiA <br /> Legal Description: -5 T- `/d N 9 Z� ..J <br /> Town: OA 14 /4"I / <br /> County: BURNETT <br /> Suhd6i�jqn/CSM: y ?y �J �S Lot No. aZ BlockNo._ <br /> PIN: 0 '7 o?D -2 L/D /G, 33 S nS'C)OV o/3-200 <br /> Pagelndex <br /> Page I 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: WADE RUFSIIOLM Credential No. 227691 <br /> Plumber Address: P.O. Box 514, Siren, WI 54872 <br /> Telephone: 715-349II-7286 <br /> Signature: <br /> Date: <br />