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Ij I i CONVENTIONAL IN-GROUND POWTS DESIGN <br /> Residential Application <br /> Index and Title Page <br /> Owner's Name: <br /> Owner's Address: 76-" 7 <br /> Site Address: Tffr�rr�� <br /> Legal{Description: S 5 j37A) ,�174 <br /> Town: _ Z_ c_p f <br /> County: 13 <br /> Subdivision/CSM: <br /> Lot No, —` Block No. <br /> PIN: h ! �� <br /> 7 0�� � 39i 7 i 5 / 03 000 of/oar, <br /> Page Index <br /> Page I 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 513 SIREN WI 54872 <br /> Signature: 1,d,f, � <br /> Date: f Phone No.715-349-7286 <br /> Designed Pursuant to the: <br /> In-ground Soil Absorption Manual for POWTS Version 2.0 SBD-10705-P(N.01/01), and <br /> SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81) <br /> i <br />