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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title page <br /> Owiier�s name: 4!r►^1Ver 6111 i 4NA <br /> Owner's address: JK&16 F'( sN�',/Ae0 ye,�! <br /> Site Address: Z 9,4$Z lOnpr Lk IGeG <br /> Legal Description: 444," TWN 40r4 A 1,4�Mj <br /> Town: y40H__ <br /> County: s�Vtr/1fE ` <br /> Subdivision Name: h4A4 0" 1-k- 6h6f'f Lot No. Zg Block No. <br /> Parcel Identification Number: ZZV C,IA= <br /> Page Ladex <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 /> Plwnber Name: /O 114,,d e, Credential No. 5/ 5� <br /> Plumhep-Address: 2 ZZO Tq mi%5oty / <br /> L'Jtobfer W 6 3 <br /> Signature: �C //'r/' 2 <br /> Date: 7"/*f--17 Phone No. <br /> Designed Pursuant to the: <br /> in-ground Soil Absorption Manual for POWTS Version 2.0 SBD-10705-P(N.01/01: R. 10112) <br /> Page I of_ <br />