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PAGE 1 OF 4 <br />Holding Tank Plan <br />Index & Cover Sheet <br />Component Manual Design References: <br />Version 2.0, SBD -10855-P (N. 03/07; R 01/12) <br />Pg 1 of 4 Index & Cover Sheet <br />Pg 2 of 4 Plot Plan <br />Pg 3 of 4 Holding Tank Specifications <br />Pg 4 of 4 Management Plan <br />Attachments: <br />Enclosures: <br />POWTS Application for Review <br />Soil Evaluation Report & Site Map (if ap <br />Holding Tank Pumping Contract if appii <br />Holding Tank Agreement if applicable) <br />Project Name / Description <br />plicable) <br />!cable) <br />Owner Name(s): )_ Phone: 2 -7 <br />AA IV <br />Owner Address: 2 c4{ala e: C ` e �' Zip: L/ <br />Project Address: 1-1320 u n -F i ©►kd <br />Govt. Lot: 1/4 of 66 1/4, Section, T 3q N -R E ❑ or W <br />Township: 4 0 `1/f County: <br />Project Parcel ID#: 0.7-0 91- 163q >L —.50/6--01zo0c) <br />Designer Information <br />Designer Name: W� ! Phone: a -3 <br />Designer Address: %�%q G �WyC— 45gri'Wh=9 1411 Zip: 7� <br />E-mail: This space reserved for approvaii scam.,. <br />License Number: 2503 <br />Remarks: <br />Signature: i Date: f % <br />Origi a signs required in each submitted copy. <br />