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PAGE 1 OF, <br /> In-Ground Gravity Plan <br /> Index & Cover Sheet <br /> Component Manual Design References- <br /> In-Ground Soil Absorption for POWrS 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 Dispersal Area Cross-Section & Plan View <br /> Pg 4 of 4 Management Plan <br /> Attachments: cl ures: <br /> POWTS Application for Review <br /> Soil Evaluation Report & Site Map <br /> Project Name / Description <br /> f-�,a ► 5 S <br /> Owner Name(s): t`1b 1 C fN,M�P iE-� Phone: <br /> - <br /> Owner Address: P6•Bo,,(6 K bt'taV -1 W 1 zip-.-50" Sy Bard <br /> Project Address: _��t ) j4W- / 76) :S <br /> Govt. Lot: iIJV(1 1l4 of S!'lil 1/4, Section_, T_n. _N-R E❑or W <br /> Township: NAE!9001`1:1 County: RUR1' T <br /> Project Parcel ID#: 'TA 4 "::�� ' <br /> Designer Information <br /> Designer Name: Q't FF EX <br /> Designer Address: Pb S n ge&cz 2 Zip: -54106(71 <br /> E-mail: <br /> V Condidonaiiy <br /> License Number: r � Z�-3�-L� Conditionally APPROVED <br /> APPBQk SAFETY AND PROFESSIONAL <br /> Remarks: DEPT.OF SAFETY AND PROF <br /> ESSIONRVICES <br /> S <br /> DIVISION OF INN AN§ER71C. INDUSTRY SERVICES <br /> i' <br /> SEE CO <br /> SEE CORRESPONDENCE 4' <br /> Signature: V ` Date: A )43 <br /> required on each Wbnt bad Copy. <br />