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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> f <br /> Owner's Name: /9ni �A-5Ki <br /> Owner's Address: 57 ,'Je.,..cv J/9-<t) 4 <br /> 5 ..+/7/1.6)/4-4..r. <br /> /�)/T ^ _5—o 5,42 2 <br /> Site Address: & S �' .> c//'r.'-€., <br /> Legal Description: 16c / G,L, 5 5.x 'T"yo/JAW( <br /> Town: /1-4( /,9-ti)cA <br /> County: BURNETT <br /> S isien/CSM: 1/ .3 /'C) Lot No. l Block No. <br /> PIN: 07 v.20 sZ `/v A o 2 s-6 S ©c A ©//e9ov <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 /> /4/ /""14 <br /> /-- <br /> Date: <br />