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CONVENTIONAL IN -GROUND POWTS DESIGN <br />Residential Application <br />Index and Title page <br />Owners name:i��� <br />Owner's address: <br />Ana# Ly i wyUZ <br />Site Address: / ,, <br />Legal Description: 40G Li` rj <br />Town: <br />County: UV rf e <br />Subdivision Name: Lot No. 417 Block No. <br />Parcel Identitteation Number: 07plol —2- r'S ZZ-rS l�'�'' 7 65t� <br />Page tndex <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 Maintenance, Management and Contingency Plans <br />Plumber Name: Cxj�i /Q ` ��er Credential No. Sal «5�I <br />Plumbe�-4ddress: Tqnv-Oy /4? <br />Signature: 75z' 4 <br />Date: 7 Phone Into. <br />Designed Pursuant to the: <br />In -ground Soil Absorption Manual for POWTS Version 2.0 SBD -10705-P (N.01101: R. 10/12) <br />Page I of <br />