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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> II Index and Title Page <br /> Owner's Name: Np y ,2e r <br /> Owner's Address: S 4-JA- t.dAr <br /> f{N olsox) 1,A1 C V0/6 <br /> Site Address: o? /, .? VJ' d rci Rd <br /> egal Description: /0 c I G, L, I S / T go. 15 <br /> Town: \r4-k5 or.) <br /> County: :URNETT <br /> Subdivision/CSM: Lot No. Block No. <br /> PI : 07 v/a? G/ S ©5 e'ol 020006 <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: <br /> Dare: 7 o7 <br />