HomeMy WebLinkAboutLauren Karantzas 610214 Permit 07 18 17.pdf4. Anticipated Date to begin Tattooing:
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Tattooing Permit
North Carolina Department of Health and Human Services
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* Permit expires 12 months after this date
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Tattoo PermitRegistered Environmental Health SpecialistByNorth Carolina Department of Health and Human ServicesDivision of Public HealthPermission is hereby granted toto engage in tattooing as defined in G.S. 130A-283atpermit valid untilCounty Expiration DateThis permit is not transferable to any other person or place of practice.Place of PracticeTattoo ArtistID NumberEnvironmental Health SectionDateEnvironmental Health SectionEHS 4016 (revised 7/12)www.ncdhhs.gov www.publichealth.nc.govThe Department of Health and Human Services does not discriminate on the basis of race, color, national origin, sex, religion,age ordisability in employment or the provision of service.82,000 copies of this public document were printed at a cost of$2260.79 or $0.027 per copy 10/132018610214KARANTZAS LAURENFOREVER INKED1630 N CENTER ST HICKORY, NC 28601Catawba07/18/201807/18/2017
Purpose: General Statute 130A-283 states "No person shall engage in tattooing without first obtaining a tattooing per-mit from the Department". The permit is issued to a tattoo artist who meets all requirements of Rules Govern-ing Tattooing 15 NCAC 18A .3200. The permit is not transferable to any other person or place of practiceand is valid for a period of one year.This form is to be used as the permit as specified above.Preparation: Local environmental health specialist shall issue a permit every time a permit issuance is indicated. Preparean original and one copy for:1. Original to tattoo artist2. Copy for the local health departmentDisposition: Please refer to Records Retention and Disposition Schedule for County/District Health Departments which is published bythe North Carolina Division of Historical Resources.Additional forms may be ordered from: Division of Environmental Health1632 Mail Service CenterRaleigh, NC 27699-1632(Courier 52-01-00)EHS 4015 (Revised 7/05)Environmental Health Services Section