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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: / �/ %TX eio e 5 <br /> i <br /> Owner's Address: j/ 3 OAR (/i L.icJ /U, <br /> Site Address: 07 Y 335 / /1 cf <br /> Legal Description: Jpc_/ G.,L y ,S !,/ 7'"Vo.tJ te I 7/ <br /> Town: 5c-o7/7--- <br /> County: <br /> 7County: :URNETT <br /> Subdivision/CSM: Lot No. --- Block No. <br /> PIN: 0,7 cia9g `/o /y U v 5 05- oc / Pa9oao <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. 10X 514, SIREN,WI 54872 <br /> Telephone: 715-349-7286 <br /> Signature: eu,Z. <br /> Date: 7- <br />