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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Narne: ja r e- 0 1-5,0 Aj <br /> O-wner's Address: <br /> e--de,A) 0 rA-i'ry e IV A) <br /> Site Address: 2-77 � :7 :7 La�e_ <br /> Legal Description: PJ a, L, S r <br /> Town: <br /> county: BURNETT <br /> p n Lot No. Block NO. <br /> o 0/2 .2 vo 0 2 0�o <br /> Page Index <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 RUFSHOLM Credential No. 227691 <br /> Plumber Address: P.O. Box 514, Siren, WI 54872 <br /> Telephone: 715-349-7286 <br /> Signature: <br /> Date: <br />