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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> �,L,l <br /> /y S' •Q-,��:ski <br /> Owner's Name: 4-/� <br /> Owner's Address: 5-V /�-'���/(' ,e: f l <br /> on-k14(e- /224) <br /> Site Address: K /, r_ <br /> Legal Description: pc I , L., / 5 ?3 TV'/1)X/ 5-4-1 <br /> Town: 3-4C_ 1< 50r0 <br /> County: BURNETT <br /> S tivt on/CSM: / �5A Lot No. / Block No. — <br /> PJN ©7 oia a 5i0 /� 023 00/ c//acre) <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: 6 —//`vZ <br />