HomeMy WebLinkAboutEHPR-04-2023-44046.tif PS
ENVIRONMENTAL
Niger 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
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Type of Proposed Establishment: ,
Was this a previous establishment?
,FIes Name if known: #Cc(3,..`h--1 e e..S U No
Type of water: Type of Sewa :
FP'ri----Jblic Water ublic Sewer
I I Well 1 1 On•Site Sewage System
I certify that the information in this application is correct.
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Signature & Date: ((/tZ4)---c-D ��,/ < -& r" Yt /
(Owner or Responsible Representative)
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4,A CATAWBA COUNTY
�' 100A SOUTHWEST BLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
C) PHONE:828.465.8399
Friday,April 14,2023
I8 2 sM www.catawbacountync.gov
PAYOR:
Bernal,David
PAYMENTS
TRANSACTION NUMBER: TRC-6 1 86563 7-1 4-04-2023
PAYMENT DATE: 04/14/2023
PAYMENT TYPE: Cash
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
04-23-421264 110-580200-663000 Food and Lodging Review Fee $75.00
TOTAL PAYMENTS: $75.00
EHPR-04-2023-44046 .._.._ ......
CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI
SITE ADDRESS: 109 HWY 321 NW,HICKORY NC 28601
Applicant DAVID BERNAL, 1663 26TH ST NE,HICKORY NC 28601
C:8282916737
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 04/14/2023 14:01 Page 1 of 1