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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: Q- o 6-, -d b G <br /> Owner's Address: 7 / 6- •t)61 11--Gee, <br /> S f /D4q/ ,- 14L. <br /> Site Address: E'//0 , ,4 rk S/. <br /> Legal Description: S / % 7 Ya z) /b cc <br /> Town: c2/ - k/, 1 <br /> County: BURNETT <br /> Subdivision/CSM: `/ ,i / 8 Lot No. 2 Block No. <br /> PIN: 0 7 0;7c? 5%a/ / 9 /SJ 3Z-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 /> Date: 1 — aj <br />