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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page / <br /> Owner's Name: I-A-CAA- <br /> Owner's Address: y 3 42 7 r' t cl A_y <br /> Site Address: a S 7� 1744�� <br /> Legal Description: -5 /3 r ye"o S" <br /> Town: J_f}G k5o.y' <br /> County: BURNETT L / I/ <br /> Subdivision/- A'//-( In00/) a 1 0 V, Y/ Lot No. C) Block No. -- <br /> PIN: 0 7 0 ZR 7yo l.5 3 s /.s a 70 o 5"c�-©0 0 <br /> Page Index <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: WADE RUFSHOLM Credential No. 227691 <br /> Plumber Address: P.O. Box 514, Siren, WI 54872 <br /> Telephone: 715-349-7286// <br /> Signature: <br /> Aez,,� <br /> 100, <br /> Date: _a 7 ' -Z <br />