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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: C. oy Z-14 �n p e r e D <br /> Owner's Address: 50 '2 0 cl c •e-i— /1 <br /> Site Address: /' SSS Z-/<-- aJ <br /> Legal Description: I'6 u� L. "S�� S /3 T�9� '/�� <br /> Town: <br /> County: BURNETT <br /> Subdivision/CSM: Lot No. Block No. <br /> PIN: 4 7 6/8 0/ coo 6/105-a <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: `Z��7 <br /> Date: I / 5 <br />