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CON`YENTHONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: /1)e/✓/;1/ 7 e s e-A) <br /> Owner's Address: !2 4X <br /> s ,M✓,//e n30 t6 eg9 <br /> Site Address: 1/33/ r vNvle-r , L)r, <br /> Legal Description: S/ 5— re/D/d'f 15) <br /> Town: aed <br /> County: BURNETT <br /> r <br /> Subdivision/�iyl: T44�v,l ert it'd Hotel, To k v Lot No. V-5— Block No. <br /> PIN: 07 a .2 go /6-I SA S / S 735- o.s 90Do <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 Maintenance,Management and Contingency Plans <br /> Plumber Name: WADE RUFSHOLM Credential No. 227691 <br /> Plumber Address: P.C. Box 514, Siren,WI 54872 <br /> Telephone: 715-349-7286 <br /> Signature: lit/ <br /> Date: - 3 <br />