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CONVENTIONAL IN -GROUND POWTS DESIGN <br />Residential Application <br />Index and Title page <br />Owners name: e4reAJ `jCXIn,,' — <br />Owner's address: Z583AI /i44h.(G Wc/ <br />Am" lel i S-tm <br />Site Address: <br />Legal Description: Cf ecA2 wL / N 7Ooj e(!6t _ <br />`Down: <br />County: 9Vi6+G/1— <br />Subdivision Name: A&4 � Lot No. 76 Block No. _ <br />Parcel ldentiticatton Number: Dy-t�►(Z-���fD�/C�'�/ /S- /1%� i%AC� <br />Page lndex <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: 45'e, �!? {R Qr Credential No. Rc�j�9s�{ <br />Plumber—Address: 2 %ZZCO <br />�,jfk-def <br />y <br />Signature: 7 <br />•-��� <br />Date: Phone No. �6G— C1.�CJ2 <br />Designed Pursuant to the: <br />In -ground Soil Absorption Manual for POIWTS Version 2.0 SBD -10705-P (N.01101: R. 10/12) <br />Pane I of _ <br />