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CONVENTIONAL IN-G'':OUND POWTS DESIGN <br /> esidential Application <br /> Index and Title Page <br /> f <br /> Owner's Name: /D 4 4 / e-rcJ <br /> Owner's Address: 35-0 c. y / ei /(�E <br /> 57'1,Jc.h fie /1 m44 s-so o <br /> Site Address: 325- .yc�i�i J /1l o v/c>d S 4) <br /> Legal Description: /I) G, L, / S/S 7i?7,01/ yet) <br /> Town: cis 1< <br /> County: BURNETT <br /> Subdivision/CSM: Lot No. — .:lock No. <br /> PIN: 07 02 c/ 2 37 /y /S .sue O S e a/ o�o o o v <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. :ox 514, Siren,WI 54872 <br /> Telephone: 715-349-7286 <br /> Signature: <br /> Date: 5''`42 V-073 <br />