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C8NVENTII NAL IN-GROUND POWTS DESIGN <br /> esidential Application <br /> Index and Title Page <br /> Owner's Name: C c.//- <br /> Owner's Address: / 3 7/L E-1.5-/0/0 A <br /> Fu Ho,J L C125-.2 <br /> Site Address: A,' o.J /6) <br /> Legal Description: c / S� -tet-' c S 2 V r,337t-' k 17 �l <br /> Town: /u <br /> County: BURNETT <br /> S isisn/CSM: V 7 P a7 5 f Lot No. 7 Block No. <br /> PIN: c -7 cc S / 7 ?9 / 0 `2/ pe,,) /yavc) <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 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: C-L) <br /> Date: y- /—�.7v <br />