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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title page <br /> Owner's name: ,CSD L- //Lj N 6 O/Y( CC3>r�6144 Iwjfw,> <br /> Owner's address: Tot 6o co pr E r't _5 14e / L-.kC /Z rJ <br /> L,+A) evS,y8L3 in A <br /> Site Address: 7 B'9£r /V i �os.e�� L/, /� . <br /> LegalDesciiption: Ac-1 .S-4J - -- <br /> Town: -3—A G /< S C rJ <br /> County: __d3_a /, /U CT/ --- - <br /> Su4&Yu �n =e: G y <br /> 5 P7 5-p / 9 /7' Lot No. g Block No. <br /> Parcel Identification Number: 0 /,?- y,2,2- V J,3 6410 <br /> Page Index <br /> Page 1 Index and Title <br /> Page 2 Plot Plan (May include septic tank and filler specs) <br /> Page 3 Distribution Cell(s)Cross Section <br /> Page 4 Maintenance, Management and Contingency Plans <br /> Plumber Name: z 1 rd L//L1 �S�d /�1 _Credential No. <br /> Plumber Address: � 5-1 —_ <br /> Signature: <br /> / —/ PhoneNo. yq -7� b <br /> 1-)ate: - <br /> Designed llursuaiit to the. <br /> In-ground Soil Absorption Mia,ual for Pow"rs Version 20 si D-10705-1'(N.01/01) <br /> Page 1 of <br />