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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: I Enclosures: <br />Owner Name(s): <br />Owner Address: <br />POWTS Application for Review <br />Soil Evaluation Report & Site Map <br />Project Name / Description <br />Project Address: v )U �F <br />Govt. Lot: _� , _ 1 /4 of _ v _1 /4, Section 2 , TSN -R ):7 E Q or W,® <br />Township: L L4 20 Y? County: <br />Project Parcel ID #: �-©3C��� �� i%—��1.� 0 -001-014-000 <br />Designer Information <br />Designer Name: Ern i f, iso, Ci t t <br />Designer Address: v7©0 -4 & /Cr x f Ad fp,, <br />E-mail: .0&4 /<,; SSG`r--,e ,: zv,- ISG klo" . & 0Y -n <br />License Number: C� Z <br />Remarks: <br />Phone: Z <br />2 1411 Zip: ,y?q 8 <br />This space reserved for approval stamp. <br />Signature: Date: <br />Original sigrfatur4reqWed on each submitted copy. <br />