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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: J 0 AA) S4/ 1,/).) /e r <br /> Owner's Address: ,2 J,9 `J Cfi;c.4j c> 4-0 e .5: c,v `7/-5- <br /> /21p/3 /ii,), <br /> Site Address: 3Yo2 � /;t) 04,) G,;-c/2 <br /> Legal Description: .5// TG/e/0 ,' / <br /> Town: J, (s a.R-% <br /> County: BURNETT <br /> SubdivisionfeSivI: 11A,� /op "boa) A),-),4))fa V i Lot No. 3 a '— <br /> Block No. <br /> PIN: .7 o%. . / i / ,6 5-0 4-//ono <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: 9- <br /> -2 O <br />