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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: I\j e_y'p y Si ff S <br /> Owner's Address: A A e>7if S <br /> _ re%s of /ate/ <br /> Site Address: e-,-AJ L AL <br /> Legal Description: � �-� 61 L S 7 'r J?Sx)�/5 4J <br /> Town: <br /> County: BURNETT <br /> Subdivision/CSM: L / Lot No. Block No. <br /> PIN: �7 �'17 07 / o S o �' oos' c3/a enP� <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.O. Box 514, Siren, WI 54872 <br /> Telephone: 715-349-7286 y <br /> Signature: -(/l/ <br /> Date: <br />