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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: /O/ /ern e..6-5 0 <br /> Owner's Address: 180,e s 'C <br /> 5 4/ 7:q <br /> Site Address: fit,/96 / 41i4r/'o'vim <br /> Legal Description: S; 3 9' 7"3 7A. /6 <br /> Town: /I')4e "0 crl,) <br /> County: BURNETT <br /> Subdivision/C- : ) SS*S sc>N j°14f of No. a 3 Block No. <br /> PIN: 0 .7 o% ' 9 57 /6 3 y 3"/-s 7,2 c39 o <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: c ,Z_ <br /> Date: <br />