HomeMy WebLinkAboutBerliner Kindl German Restaurant Permit 730257 10 08 10.JH.pdf[]am
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B E R L I N E R K I N D L G E R M A N R E 5 T A U R A N T
Name of E staDfishment
1 a 1 B R 0 A D W A Y
Address;
B L A C K M 0 U N T A I N N C a 8 7 1 1
cdy� State: -Zip:
S H A R 0 N T R U B E
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Phone
Fax Emergency Phone Number
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Email Address: -ountyi
5-5 - Municipat(Community 3.3 - Municipat(Community NJA 01
Water Supply Wastewater System Risk Category Territory ;; capacfty
0 1 5 7 73 - Temporary Food
Facility M [] ExiSting F aClfity7 0 to F a 64ty IN: Operate aStatus Code
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Lat, Long, Date:
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Push Cart or blFU Name
Transitional Permit, Conditions: Permit Ex0res: EJ90 days Ej ISO days
Non-Comphant items cornpMed by:
ConefitionsRernatlks
Establishment Assigned To:
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M anagertPerson in charge
1 0
Title Date:
NC Department of Environmental & Natural Resources Pia Transition
Division of Environmental H afth
Date-, 1010812010
Name of Establishment, LINER KIN L GERIJA t RESTAURANT Permittee. SHARON TRUBE
Location Address: 121 BROADWAY ManagenPerson in Char
i BLACK MOUNTAIN State, NC Zip° 28711 County, 1
Billing dame- SHARONTRUBE Status Gode I
130ing Addii 121 BROADWAY Estabfishment ICE, 2018730257
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Bait ', BLACK MOUNTAIN State, NC Zip: 28711 . --------------- Parcel fCt:
mail Address: Lat----------------- . Lonj,................
Phone Fax- Emergency Phone Number
rrtalsston rs granted to operate a 7 - Temporary Food Establishment as defined in G,S, 1 247(1) and 1; A- 4 ,
Regulation of Fundand Lodging Facilities. See permit requirements in Rules, This permit is not transferable and may be revoked for failure to
comply with all requirements,
Wastewater Systems: #MunicipailCommunioy On -Site ystern capacity„ Category : �
Water supply tit unicupaUCornmunmty ri-Site system
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Pu h artrM obrle Food UMI: operating in conjunction tF&tW
Restaurant or CommissarQy Name and 15 nji5 eY `---------
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Establishment assigned to 1654
Transtitional Penn it CiandMons
This permit shall expire on and is not renewable Alt non -co pliant items listed herein and on attached pages tit
applicable) must be completed within 4 ISO days days, This establishment must close if MI noncompliant items are not corrected by the
expiration date.
Received By Tillie: Date: 101081 1
t�anapeilersnn in Charge
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