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PAGE 1 OF 4 <br /> Holding Tank Plan <br /> Index & Cover Sheet <br /> Component Manual Design References: <br /> Version 2.0, SBD-10855-P (N. 03/07; R 01/12) <br /> Pg 1 of 4 Index & Cover Sheet <br /> Pg 2 of 4 Plot Plan <br /> Pg 3 of 4 Holding Tank Specifications <br /> Pg 4 of 4 Management Plan <br /> Attachments: Enclosures: <br /> POWTS Application for Review <br /> Soil Evaluation Report & Site Map (if applicable) <br /> Holding Tank Pumping Contract (if applicable) <br /> Holding Tank Agreement (if applicable) <br /> Project Name / Description <br /> Owner Name(s): ell y)ct /Me Phone: I Z -3 '--2d70O <br /> Owner Address: Z Q( " . G>' V,c vv Dr (rr rltslv 'G l p: Sof r L1L) <br /> Project Address: 11 <br /> Govt. Lot: 1/4 of /1 0/1/4, Section Z i , T 37 N-R )2i) E or WW <br /> Township: Tr.�� �� w 62 County: 8,,4 <br /> Project Parcel ID #: 0 o c'Sti - • 7-1� j --� (� C:�QZ-01Z. 006 <br /> Designer Information <br /> Designer Name: Pat Kissack Phone: 715 -520- -2335 <br /> Designer Address: W7003 Rappy Lake Rd., Trego WI 54888 Zip: 54888 <br /> E-mail: Patkissack@yahoo.com This space reserved for approval stamp. <br /> License Number: 881072 <br /> Remarks: <br /> Signature: -1J4) ---,A,4. 4Date: <br /> ginal sigrequired on each submitted copy. <br />