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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> WITH DOSE CHAMBER <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: e <br /> Owner's Address: g..?1 lul <br /> Site Address: 5-618 7 $-f—/0- 7 7 <br /> Legal Description: pc.� 5 17 <br /> c <br /> Town: <br /> County: BURNETT <br /> Subdivision/CSM: Lot No. — Block No.— - <br /> PIN: 07 0.3,Z .2—y1 /.S/7 S—C S 4203 0/7ood <br /> Page Index <br /> Page 1 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 Dose Chamber Cross Section (with ST &filter specs) <br /> Page 5 Pump Curve and Specs <br /> Page 6 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: <br />