HomeMy WebLinkAboutRumours Tattoo Studio Joshua McJunkins App 610217 04 06 23 0 ENVIRONMENTAL HEALTH
Catawba County Government Center
Catawba county 25 Government Drive I P.O. Box 389 I Newton, NC 28658
public health Phone: (828)465.8270 I Fax: (828)465.8276
MANINO.LIVING NI TTIN.
Email: EHAdmin@CotowbuCounlyNC.gov
FLIov7-O °n
1 Application for Tattooing Permit f,, /�,
Date of Application ( 1 �j �A3 ID )V 1{U lY I(`i7
Tattoo Artist E orr atioo:
First Name ��ISV\V A— Last Name 1 " 1 C_( )i".4 v-)S MI CO
Mailing Address: ca R(4Pr C l 6.4 r I ; ,t
City 7(V\ State / IC Zip .93 -.5----4,
Telephone Number: f 7151 O / 5 Q. E-mail: 0.r�`S�1 C-�v^'� Cp,_ , (D I r.,, ,/ l.g o .C o✓`-.
Tattoo st sh e t Information:
Name of Establishment: �f"16 v rs 66 S'cJ C)
Street Address: 9 6 1 - )--C w -7051N
City \---t 4C State C Zip u'6 60
Business Hours: Pei 8 ►•L
(7
Number of Tattoo Artists in Establishme AMici Begin Tattooing: AC/4
Tattoo Artist Signature:
Instructions
Purpose: To allow tattoo artists to apply for tattooing permits a s required in General Statute 130A•283 and I5A NCAC I 8A.3202. A
separate application must be completed for each permit.
Preparation: Each tattoo artist must complete and sign a separate application for each location where he or she will engage in tattooing
within the State of. North Carolina. The completed application must include the full name, mailing address and
signature of the tattoo artist, the name and street address of the tattoo establishment,and the anticipated date of
commencing operation.
Submission: The completed application must be submitted to the local health department in the county where the tattoo establishment is
located at least 30 days before commencement of operation. The local health department may require payment of fees or
additional information upon submission of the application.
Disposition: This form may be destroyed in accordance with Standard 7 of the Records Disposition Schedule.Published by the N.C.
Division of Archives and History.
DENR 4015(Revised 11/00)
Environmental Health Service Sedion(Review 11/03)
4p CATAWBA COUNTY
i� Ill�� 100A SOUTHWEST BLVD
. . _ ._NEWTON,NORTH CAROLINA 28658 - RECEIPT
1-3
PHONE:828.465.8399
V Thursday,April 6,2023
/8 Z ski www.catawbacountync.gov
PAYOR: Rumours Tattoo Studio
Rumours Tattoo Studio(McJunkins,Joshua)
PAYMENTS
TRANSACTION NUMBER: TRC-61281221-06-04-2023
PAYMENT DATE: 04/06/2023
PAYMENT TYPE: Credit Card
303415404
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
04-23-420950 110-580200-663000 Tattoo Artist Fee $225.00
TOTAL PAYMENTS: $225.00
FLI-08-2017-089020
CASE TYPE: Food&Lodging Institutions WORK CLASS: 61-Tattoo Artists
SITE ADDRESS: 2508 US 70 HWY E,HICKORY NC 28602
Applicant RUMOURS TATTOO STUDIO,2508 US 70 HWY E,HICKORY NC 28602
B:8288553157C:7047180152
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 04/06/2023 13:12 Page 1 of 1