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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: RCA) O r7' y* / 7 $' 7"r 57 <br /> Owner's Address: 3 G-etc 5 <br /> le re; 6 d cf v <br /> Site Address: , 3`/77 ri-z /'/+A L icJ' <br /> Legal Description: P c-/ 6, L, - '/7 7- 3$v' ( / y <br /> Town: V <br /> County: BURNETT <br /> Sul ision/CSM: V / /- /8'7 _ Lot No. / Block No. <br /> PIN: © 7 0o8 a .75 /S/ / ' S o S Of 0/5—occc> <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: Y `/-.2.2 <br />