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CONVENTIONAL IN-GR I UN* P twits DESIGN <br /> Residential Application <br /> Index and Title '"age <br /> Owner's Name: JQ o.X 4 19-s—/1'i*, <br /> Owner's Address: , 96o? 5– RPS e nk r, <br /> M- ) ti y Gel,V 6—e g <br /> Site Address: -'9/i e- <br /> Legal Description: y0c.,/ G-, L• `/ 5 3 3 'Tell ft) / (.4J <br /> Town: SGC)/3 5 <br /> County: BURNET JT <br /> Subdivision/CSM: Lot No. — :lock No. <br /> PIN: D7 o3a V/ /6 33 S os004V o/.?co ? <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 'UFSHOLM Credential No. 227691 <br /> Plumber Address: P.O. !:ox 514, Siren, WI 54872 <br /> Telephone: 715-349-7286 <br /> Signature: o <br /> Date: <br />