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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: � � ��^4— <br /> f <br /> Owner's Address: / 3 .� <br /> Site Address: /`6/, /��/G <br /> Legal Description: - yeti j� c") <br /> Town: /4 i,,,t t d <br /> County: BURNETT <br /> S' iviston/CSM: __Y 1l. /,J 3 Lot No.__7 _Elock No. <br /> PIN: © c3o y ©/�o C� <br /> Page Index <br /> Page I Index and'Title <br /> Page 2 Plot flan(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: WADE l[ UFSTIOLM Credential No. 227691 <br /> Plumber Address: P.O. Box 514, Siren, WI 54872 <br /> Telephone: 715-349-7286 <br /> Signature: <br /> Date: <br />