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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title page <br /> Owner's name: r;,s U i kofj �f <br /> Owner's address: 11370 ire m �k�W <br /> lyc-d- <br /> Site Address: / Q <br /> Legal Description: ftt F6- I W^13 <br /> ✓7+f i l�W <br /> Town: J�lG I/, <br /> County: A,(A/c#- <br /> Subdivision Name: Lot No. Block No. <br /> Parcel Identification Number: 0'7-df#-Z47-YB C,'f 0,?1OW-O1l000 <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 /> / 1 <br /> Plumber NamImo <br /> e: " -0— llq der Credential No. 85/9`57 <br /> 7 <br /> Plumbm-Address: 7ZZ0 TgrPj%5pnt A <br /> Signature: rl /; ' <br /> Date: /� Phone No. <br /> Designed Pursuant to the: <br /> In-ground Soil Absorption Manual for POWTS Version 2.0 SBD-10705-P(N.OIIOL R. 10/12) <br /> Page I of <br />