235 Conservation Commission 2018 BOARD OF HEALTH
CITY OF NORTHAMPTON
DONNA C.SAIlOOM,CHAIR [J }'
SUZANNE SMITH.M.D. �a T�7)1
JOANNE LE\IN,M.D. MASSACHUSETTS 01060 . It ,.
• OFFICE OF THE 44.7„;-„,.re
euSdMr Wood,MPH.Director BOARD OF HEALTH
J SndsSA ear,MPH.Health imputeHeats 212 MVN STREET
Pebitle Abbott RN.Public Nurse NOR212 MPTON.MA 01060
Hasler McBride,0S4 (413)587-1214
FAX(413)587-1221
Onsite Septic System Construction Permit: Conservation Commission Review
NOTE: As of 1!1!11, Septic System Permits will not be issued by the Northampton Board of Health
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
SLaVtllevanorthamDtonma.Rov
Office of Planning&Development
210 Main Street, Rm, 11,City Hall
Northampton,MA 010601Rider
C nn // 1� I
Property Owner: rtoSe�KrAddress: ;35 (pies /"leccJJOk1
II fROr_e-'
Engineer. III steruL
(I I
Cors=rvatio ommission Conservation, Preservation and Land Use Planner
Date: 10-4/M