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PAGE 1 OF 5 <br />Pg 1 of 5 <br />Pg2of5 <br />Pg3of5 <br />Pg4of5 <br />Pg5of5 <br />Attachments: <br />In -Ground Dosed -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 />Pump Tank Specifications <br />Management Plan <br />Pump Curve I POWTS Application for Review <br />Soil Evaluation Report & Site Map <br />Project Name / Description <br />Owner Name(s): <br />-7a /7 <br />JO % f f <br />Phone: - <br />Owner Address: <br />'aGI S ' � <br />� <br />C Ka � (P�(l <br />i e_t' ���1 <br />a h p: `� — <br />Project Address: <br />-1 T <br />Govt. Lot: 1V 6 _1/4 of C-7 W1/4, Section_, T3 3 N-R)E ❑or W <br />Township: L a -L ) le HC? County: Isid�' n eA <br />Project Parcel lD#:(�:�Ooq-n" <br />Designer Information <br />c <br />Designer Name: P-424 le sr k <br />Designer Address: <br />E-mail: Y)a �_Zi <br />License Number: <br />Remarks: <br />�t/1/5 IF? <br />Signature: I�Z�eDate: —(70—/ <br />Original signature required on each submitted copy. <br />