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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and`` Title Page <br /> - <br /> Owner's Name: 'c' -f'i9 /off` <br /> Owner's Address: 42 8'6 C /707% 571: 4)5 <br /> Site Address: F-a <br /> Legal Description: A l Ai c — )t S 7-3 q 4)if i Lir <br /> Town: U S <br /> County: BURNETT <br /> Subdivision/CSM: Lot No. Block No. <br /> PIN: O70 Z '� a 37 1V a ' / 0/ ncccc 0/.26c) 0 <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: 1. 4 <br /> Date: 5'—a7 C --/y <br />