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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: �c-,79 0-0 flcj/-ti3 <br /> Owner's Address: 3 6 75 ,��j E--jJr /e) <br /> e// L,qke 6-v / <br /> Site Address: <br /> Legal Description: pc,/&, 4, 3 5/ 13 g'tii 1f/s <br /> Town: L/4 Co e �'- <br /> County: BURNETT <br /> Subdivision/CSM: Lot No. Block No. — <br /> PIN: O7 o/Y a 38 is o/ 5 ca5- oe>3 o/7000 <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: 6e.)�� <br /> Date: /J 9--'74) <br />