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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: <br /> Owner's Address: 01--23 AV_ ZI/rA/ o 14k C-7L <br /> Site Address: 2 7 61 6/ GrA 2.5 /Ci� <br /> e.,egal Description: �Pe 6, L, — 7 7"Lf 6/fi <br /> Town: C 5 AA)d <br /> County: BURNETT <br /> Stbdli nm7jn/CSM: V o2� a 7 Lot No. / Block No. <br /> PIN: o7 oR0 -2 z10 7 C»6 6/1?00CD <br /> Page ludex <br /> Page 1 Index and Title <br /> Rage 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: MADE R70FSHOLM Credential No. 227691 <br /> Plumber Address: P.D. Box 514, Siren, WI 54872 <br /> 3.elephone: 715-349-7286 <br /> Signature: <br /> Dare: /D 7 —07_7 <br />