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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: Gr,r ki <br /> Owner's Address: 1.3 AV Ad <br /> c) S s/,- <br /> Site Address: $ O A4('k $ <br /> Legal Description: ,,5 L 5`0,-J /6 C <br /> Town: O A k/, ,L) <br /> County: BURNETT <br /> L <br /> Subdivision/: �e�vSe•►JS LfFke 5 �� Q;✓�,'ye/%o iNo.v2 +v?Block No. <br /> PIN: o 1 o ao 2 Yo 16 /7 S /s' <br /> Page Index <br /> Page I 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 /> Date: i2 <br />