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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> WITH DOSE CHAMBER <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: � 'U l .S VI'e &) <br /> Owner's Address: -fe 0-p c e- b r. <br /> Site Address: t-104d#q e_ /e <br /> Legal Description: T't_/& /k j j e j <br /> Town: S'uo 5 <br /> County: BURNETT <br /> Subdivision/G M: AA 10_5 e i,,i°Sk;d e.rule-cd / + k.Lot No._,Z Block No. <br /> PIN: 6 302 a? 5/ /6 -7S`S` 5- 3S/ cs Z.z vot, <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 Dose Chamber Cross Section(with ST& filter specs) <br /> Page 5 Pump Curve and Specs <br /> Page 6 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 /> 1 <br /> Signature: � � '' `.►�� <br /> Date: <br />