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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> //Index and Title Page <br /> Owner's Name: 5 f'e / e "ise, t.) A('M S <br /> Owner's Address: ''/ 7 7 / c/C.CA- Aff <br /> e-- J 51 '6 / <br /> Site Address: C C /9cil <br /> Legal Description: G-,Lr 3 S %/ 7-Vo.ra41 G e.,.J <br /> Town: Ot4 K/, NcJ <br /> County: BURNETT <br /> Subdivision/CSM: Lot No. --- Block No. — <br /> PIN: 07 O O a VD /6 I/ 5 o oo3 0//o 0 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--33499-7286 <br /> Signature: <br /> Date: <br />