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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title page <br /> Owner's name: � y `�//q/�Jj�(Jci�lt <br /> Owner's address: <br /> &%14 <br /> Site Andress: <br /> Legal Description: 4ee,11 f*O ��Sw <br /> Town: ,J I, (�AGirhO ?-jCounty: Auif`�Gf'� <br /> Subdivision Name: Lot No. Block No. <br /> Parcel Identification Number: 600 <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: /6 fo �,~XAe✓ ,Q' Credential No. �y <br /> Plumber Address: Z-70,769-0h4.CY A6 <br /> Wd4ler W '" <br /> Signature: p rat <br /> Date: z Phone No. <br /> Designed Pursuant to the: <br /> In-ground Soil Absorption Manual for POWTS Version 2.0 SBD-10705-P(N.01/01) <br /> Page 1 of <br />