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17 Septic Permit 2012 OF HEALTH BALLOOM,CHAIR IE SMITH,M.D. E LEVIN,M.O. food,MPH,Director IPH,Health Inspector RN,Public Health Nurse r McBride,Clerk CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH (413)587-1214 FAX(413)587-1221 212 MAIN STREET NORTHAMPTON,MA 01060 Se tic S stem Construction Permit: Conservation Commission Review a of 1/1/11, Septic System Permits will not be issued by the Northampton Board of Health sceive this form signed by the Northampton Conservation Commission Staff Member. >ervation Commission can be reached by contacting: O Sarah LaValley,Conservation,Preservation and Land Use Planner SLaValle y n°rthamptonma. ov_ Office of Planning&Development 210 Main Street, Rm. 11,City Hall Northampton, MA 01060 ty Owner: :er: StCRuTFF . J — tNt end -tiD P CelAk rev'eu) re�t,�ire II :rvatio-Co M-sion Conservation, Preservation and Land Use Planner Address:/ 7 0 if yew � t)