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Pg 1 of 4 <br />Pg2of4 <br />Pg3of4 <br />Pg4of4 <br />Attachments: <br />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 />Index & Cover Sheet <br />Plot Plan <br />Dispersal Area Cross -Section & Plan View <br />Management Plan <br />EnCIOSL <br />POWTS <br />lication for Review <br />Soil Evaluation Report & Site Map <br />Project Name / Description <br />Owner Name(s): l� y� %�L�c�_ fr!✓/ Phone: -7) <br />Owner Address: 252.5 (2- 'z �IS�c�t� V Zip: <br />Project Address: 1 i <br />Govt. Lot: 1/4 of � W1 /4, Section , T�N-R E or W12!�J <br />Township: L� yl r, 0 % 4 County: L /zrje�4 <br />Project Parcel ID #: O�! D �(�2 "J 1 �2 a;33 ()Q 00 (3 D 12 UOD <br />Designer Name: rCk <br />Designer Address: k/ <br />E-mail: <br />Designer (Information -�s <br />I �, C, /� Phone: l 1.5- '�.�" <br />Z i <br />License Number: <br />Remarks: <br />Signature: AlfDlv, Date: — <br />Original si atur requir d on each ed copy. <br />