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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: 186 �j jj l-cPrr-j <br /> Owner's Address: -33 /Y ,C) r1 er <br /> Site Address: .s/�/Y1 ca ,` <br /> Legal Description: 6 J G,L,/ .S Z 9 T ye) /J )( l z <br /> Town: <br /> County: BURNETT <br /> Subdivision/CSM: V/gZ /3 Lot No. a Block No. `Y <br /> PIN: 0 -7 0,-?S' S ©_S- ®al dj,?C-no <br /> Page Index <br /> Page I 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,-�34)9-7286 <br /> Signature: lig ' <br /> Date: 81-9 F <br />