36_-248_letterAH 46 Maple Ridge Rd- notice of intent310 CMP, '0.99Y --
Form 3 DEP rife no. 246—�
—
ed�114
%(ro t» as try DEP)
y� Commonwealth
of Massachusetts - City, Town Northampton
'ic
Notice of Intent`— `='-'=�
Under the i Lrmit-
&
Massachusetts Wetlands Protection Act .1 §40
and
Application for a Department of the NORTHAMPTON WETLANDS PROTECTION ORDINANCE
Part I: General Information LC -,,.D
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AS
1 . Location: Street Actress
ASSESSORS' MAP ID •
Lot Numoer AS�E ..Ni r ��--- �•_-��y
2. Protect: Yoe 51 Description
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Adcress
12 NAS olol�
7. a. Have the Consen�ation Commission and the Departments Regional Office ezarctns a Qn�ocumen sent, by rnfieo
mail or h� oeiivery, 2 copies of completed Notice of Intent, with supporting g P
Yes tio No - ��
b. Has the fee been submitted? Jl Tes - N
c. Total Filing Fee Submitted State Share of Filing F
d. City/Town Share of Fling Fee (Vi of fee in excess of Sts, sent to DE?)
(sent to City(Town) the applicant calculated the fee? �es - No
e, is a tr;ef statement a-acned indicating how
f. Permit requested under: Mass. Wetlands Protection Act (310 CMR 10):
Northampton Wetlands Protection Ordinance:
Effective 11, C/89
Boo'
&Page '
3. Registry' Ccunry Hampshire
—Current
Certificate (If Registered
Land)
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Tel. •
—
4. Applicant -
S�
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r�na� VY6� of olio
_ Adcress b
Tel.
5. Property Owner
_ p��yO,
'c'��/ n
► I _ .11. �� 6
( i
Address
i
J t 1
Tel.
— B. Reoresen;anve
Adcress
12 NAS olol�
7. a. Have the Consen�ation Commission and the Departments Regional Office ezarctns a Qn�ocumen sent, by rnfieo
mail or h� oeiivery, 2 copies of completed Notice of Intent, with supporting g P
Yes tio No - ��
b. Has the fee been submitted? Jl Tes - N
c. Total Filing Fee Submitted State Share of Filing F
d. City/Town Share of Fling Fee (Vi of fee in excess of Sts, sent to DE?)
(sent to City(Town) the applicant calculated the fee? �es - No
e, is a tr;ef statement a-acned indicating how
f. Permit requested under: Mass. Wetlands Protection Act (310 CMR 10):
Northampton Wetlands Protection Ordinance:
Effective 11, C/89