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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> esidential Application <br /> Index and Title Page <br /> Owner's Name: &rel <br /> Owner's Address: 7t.7C �14f�/mak A-ye, <br /> md6u,y <br /> Site Address: a 75-37 j-e.5. it- 4 r <br /> Legal Description: _5 3 3 7-90/0A6/6 CeJ <br /> Town: r4/C. <br /> County: URNETT <br /> Subdivision/ J2 S S j 4 it-cic" Lot No. 7 Block No. <br /> PIN: 0`7 c d VD IC 33 5- ,_,3‘2 o f 7©cp0 <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: <br /> Date: ,�._/.7 pZ <br />