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249 Lot5 Conservation Review2015 BOARD OF HEALTH KHA ip CITY OF NORTHAMPTON aoR. 4 , DONNA C.SALLOOM. CHAIR `'�i SUZANNE SMITH,M.D. MASSACHUSETTS 01060 s . �� JOANNE LEVIN, M.D. % . OFFICE OF THE — �= M, Benjamin Wood,MPH,Director BOARD OF HEALTH A„ Daniel Wasiuk,Health Inspector Edmund Smith, Health Inspector (413)587—1214 212 MAIN STREET Patricia Abbott, RN,Public Health Nurse FAX(413)587-1221 NORTHAMPTON,MA 01060 Heather McBride,Clerk Onsite Septic System Construction Permit: Conservation Commission Review NOTE: As of 1/1/11, Septic System Permits will not be issued by the Northampton Health Department until we receive this form signed by the Northampton Conservation Commission Staff Member. The Conservation Commission can be reached by contacting: 0 Sarah LaValley,Conservation, Preservation and Land Use Planner SLaVallev(a)northamptonma.Rov 587-1263 Office of Planning& Development 210 Main Street, Rm. 11,City Hall Northampton, MA 01060 i L,.+- -4-5 Property Owner: PA.,/,0' E HesrA(.0.4) a fielcrile,±Address:Syivcsi-er ,moo .______. , - . Crorrvierly Engineer: i )nn cl ,k.),,)ts ) o Mk LV, d aby ;t _ Gr; �1iCfi'sn�Q resawicte 'grew- - e; - Con rvation .mm n Conservati s ry reI n an se Planner 6 i-ect Date: . , ci • i, ./ i 0 , \17.______ , , nil/ 1 / 0 / , \‘..„,...vti :. Ito :t / —kia '-1..--N--R--3‘k\7-... \ \'), ) (111)y‘' \ 19, f14411--) • (R .„ 1 st.,EAORTAL s -//' C% \s'• ' \ `iv 4 " 1(7:"44,..,:m.,,,, . . ‘........, ..s-, -. •.....\\ ../. , -... ,,,, \-.r.. 4::, 11.-- • ", '' • ,,,I ...}. / / _ ..... ... ,4II • , , •411''11'.;fir '4116.N, .4\\ 1 '3t* *4.:' _ -- - „, / , •-• v. ,19 •. 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