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PAGE 1 OF 4 <br />In -Ground Gravity Plan <br />Index & Cover Sheet <br />Component Manual Design References: <br />Version 2.0, SBD -10705-P (N.01/01, R. 10/12) <br />Pg 1 of 4 Index & Cover Sheet <br />Pg 2 of 4 Plot Plan <br />Pg 3 of 4 Dispersal Area Cross -Section & Plan View <br />Pg 4 of 4 Management Plan <br />Attachments: <br />POWTS Application for Review <br />Soil Evaluation Report & Site Map <br />Project Name / Description <br />J <br />Owner Name(s): I r Tr K No i- F r Phone: - - <br />Owner Address: 30,E 5- H A I I - E'( L )j E8 Q L 1-410, �F L4T- Zip: S�1 7 al <br />Project Address: 7 5- 3 t Y, C (1 15 z/) Ni> 0 <br />Govt. Lot: 1/4 of 1 /4, Section_, T `10 N -R % `1' E ❑ or W <br />Township: co -r-V- County: <br />Project Parcel ID #: o? 53 a '10 14 1 8 So 57 o o 3 o t goo o <br />Designer Information <br />Designer Name: Dan Burch <br />Phone: 715 -416 -1642 <br />Designer Address: N5921 Cty Hwy K Spooner WI Zip: 54801 <br />E-mail: burchplumbinginc@gmail.com -fl,is space reserved for approval stamp. <br />License Number: 253808 <br />Remarks: <br />Signature: Date: <br />Original signature required on each submitted copy. <br />?,-d ?- 7 <br />