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kyx aMLLna PAGE 1 OF 4 <br /> Index & Cover Sheet <br /> Component Manual Design References: <br /> ttoMtrTg--Ian Version 2.1 (May 2022-2027) <br /> Pg 1 of 4 Index & Cover Sheet <br /> Pg 2 of 4 Plot Plan <br /> Pg 3 of 4 Holding Tank Specifications <br /> Pg 4 of 4 Management Plan <br /> Attachments: Enclosures: <br /> POWTS Application for Review <br /> Soil Evaluation Report & Site Map (if applicable) <br /> Holding Tank Pumping Contract if applicable) <br /> Holding Tank Agreement if applicable) <br /> Project Name / Description <br /> Owner Name(s): MARCIA LAGRANDER&ANNE MARCINIAK Phone: - - <br /> Owner Address: 4044 LONGFELLOW AVE, MINNEAPOLIS, MN Zip: 55407 <br /> Project Address: 27980 N POINT LAKE RD , WEBSTER, WI 54893 <br /> Govt. Lot: 1/4 of 1/4, Section 28 , T 40 N-R 15 E❑or W ❑✓ <br /> Township. JACKSON County: BURNETT <br /> Project Parcel ID #: 012-422-80-2200 <br /> Designer Information <br /> Designer Name: TRAVIS BUTTERFIELD Phone: 715 -634 -8176 <br /> Designer Address: 14346W ST. RD 77, HAYWARD, WI Zip: 54843 <br /> E-mail: office@butterfielddrilling.com This space reserved for approval stamp. <br /> License Number: 652879 <br /> Remarks: <br /> g-3 I- a3 <br /> Signature: Date: <br /> Original signature required on each submitted copy. <br />