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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> WITH '?INOSE CHAMBER <br /> s'"esidential Application <br /> llaSdex and Title Page <br /> Owner's Name: Ro' S0 mo/ 5 a <br /> Owner's Address: 02 O 7 o 3 3/22) <br /> p i ury .5-vso <br /> Site Address: -09/11 Lo, <br /> Legal !llescription: /J.5 '7-/ to /P /5- <br /> Town: <br /> -Town: 3AC s.) <br /> County: is URNETT <br /> Subdivision/€-SM: 71-o, f-5'/Ori�?> cid Jo laLot No. 5 7 Block No. — <br /> PIN: d 7 0/o2 a VO /5' /s"S/s 7sy 6 q ooc) <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 RUFS OLM Credential No.227691 <br /> Plumber Address: P.O. i:OX 514, SIREN,WI 54872 <br /> Telephone: 715-349-7286 <br /> i <br /> Signature: <br /> Date: _.2 <br />