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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> WITH DOSE CHAMBER <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: '5 4}w,J Z.4 G/7 iv e ( <br /> Owner's Address: ‘,/e <br /> 57-/Ay/ /y1v 7 <br /> Site Address: 7.5'd i le-Ats ky , J <br /> Legal Description: Dcl/ 6-, I.. ! 5 s7l 0,c)e/6 J <br /> Town: ji4c-k 5 <br /> County: BURNETT <br /> Subdivision/C C./C.,4( 5 ky /4'C-Ce 5 Lot No. 2/ Block No. <br /> PIN: 07 c/ /`/a /o'ers1 .5'/ /DO o3; ocor) <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 Dose Chamber Cross Section(with ST & filter specs) <br /> Page 5 Pump Curve and Specs <br /> Page 6 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: F —36 -20.2 <br />