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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> r-- <br /> Owner's Name: ►J e.!4e,ft)y <br /> Owner's Address: 7/ 7 5 DA-ic.40 oc:J P wf <br /> GJ e tshe r b Sy773 <br /> Site Address: 7/7 o A-K coo / kwy <br /> Legal Description: S 2 73 7 Ai 'F !6 <br /> Town: /n f p <br /> County: BURNETT Subdivision/E-�SM: C}/14 U o el d Pi4-('IC- Lot No. Block No. — <br /> PIN: t7 o/' /6 ,2$' a / 55 ? of.ZOea <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: d Goa- <br /> Date: <br />