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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: 5C."4-AJ ,c)s�sti1 <br /> Owner's Address: ,:: 3(-110 D /9-11e &= <br /> /64-ni Lk n-I.J , s5-30 <br /> Site Address: 3 75 3 /).74/i . l j <br /> Legal Description: -1-416 nJ ,P i 5 4J <br /> Town: 34c1(.So nJ <br /> County: BURNETT <br /> Subdivision/ : L!)>,J?c r Y.;11 Aid V I�/ <br /> Lot No. g 4-1 Block No. -- <br /> PIN: 07 cid eiq VC, 1.5— >Z 3 5 / s '5-g 6 /l ao() <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: /D 3/v2 <br />