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C•WENT'I NAL IN-GROUND POWTS DESIGN <br /> WITH DOSE CHAMBER <br /> Residential Application <br /> / Index and Title Page <br /> Owner's Name: G/c-r j 1' / ly <br /> Owner's Address: `/7o 7 /5Y9�� G'7L <br /> 40,4- V2//e7 /Wr0 53779 <br /> Site Address: 38C Lk <br /> Legal Description: Dc.l G, L, .27,2 .5.75/ 7 -Y49 d,P/5 <br /> Town: \Th -k 5 cy <br /> County: BURNETT <br /> S ion/CSM: V c//4 25T.7 Lot No. / Block No. <br /> PIN: 07 o/a 5/a /5 z S o S ot..3 /loco <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: G%U <br /> Date: ", � � <br />