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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> WITH DOSE CHAMBER <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: /Lb L ),(42 l( oS k 1 <br /> Owner's Address: 3 q 7 02, aJ5 e: )Je <br /> g C X S4,/ 76 I� <br /> Site Address: ,�? l��0 &r.* -e.. 40 <br /> Legal Description: <br /> Town: S �•cJ��� ,S <br /> County: BURNETT <br /> Subdivision/CSM: Lot No. -- Block No. <br /> PIN: 3 0/ 000 0/l va6 <br /> Page Index <br /> Page 1 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 Dose Chamber Cross Section(with ST & filter specs) <br /> Page 5 Pump Curve and Specs <br /> Page 6 Maintenance, Management and Contingency Plans <br /> Plumber Name: WADE RUFSHOLM Credential No.227691 <br /> Plumber Address: P.O. BOX 514, SIREN, WI 54872 <br /> Telephone: 715-349-7286 <br /> Signature: <br /> Date: <br />