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CONVENTIONAL IN-GROUND POWTS DESIGN <br /> i esidential Application <br /> Index and Title Page <br /> Owner's Name: ,4-afYrrl J 9Lk <br /> Owner's Address: 30/5 ,4 5/0 e- D Th-((' <br /> 4f}n36ti t G,)•T 9/S3a <br /> Site Address: S4-.' 1 2 <br /> Legal Description: .S 7 T y6 N <br /> Town: Ste-o <br /> County: BURNETT <br /> Subdivision/eSitA: 512 f'i t G-ree t' Acid, t V VLot No. 7o Block No. — <br /> PIN: o 7 028 .2 yo is/ c 7 S /5 704' o7S ooti <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: ( dctoi--/c74,1-0)-6C- <br /> Date: <br /> c %rDate: /.2-/9-,2b <br />