HomeMy WebLinkAboutIsabel Juarez INJ Beauty Makeup & Skincare 610338 app 07 07 23 L -
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 Fax: (828) 465.8276
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Email: EHAdmin@CatawbaCountyNf.gov
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Applicationfor Tattooing Permit
n ;iI� �01%o � .33$
Date of Application �-� �
Tattoo Artistt Information: n
First Name �Cll�� n / last Name V C 1 MI 1 V
Mailing Address: (-0 c T a Ck AvQ Y V C. AO • CT
City 4 1 i C [){ State N1 C Zip 2—S U,O
Telephone Number: � r, G.M,7 1 E-mail: 1 SG,►X ACKeZ— ,l` ` �.` Imo" �' `"S'\
Tattoo Establishment Tn.forixiatisn:
Name of Establishment: lv tiJ?(AM 4() \AC 4 CcW
Street Address: 2(62i) j,1,2 th �'t (=� .
City ,plS 1 State NC Zip 2 LQ C
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Business Hours: , L f 1 l Coctm - �Cf r`C1 11-1)i , �`•QL • la 2)0rh" -C Cif V - Yv • S Cl/(1
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Number of Tattoo Artists in Establishment 1 Anticipated Date to Begin Tattooing: �, �3 .2
Tattoo Artist Signature: _
Instruction '
Purpose: To allow tattoo artists to apply for tattooing permits a s required in General Statute J 30A•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.
DEN 4015(Revised 11/00)
Environmental Health Service Section(Review 11/03)
OA- Co CATAWBA COUNTY
��'� G� 100A SOUTFIWEST BLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
►� PHONE:828.465.8399
U �4►� Friday,July 7, 2023
I g 4 2 snt www.catawbacountync.gov
PAYOR: INJ Beauty Makeup&Skin Care LLC
INJ Beauty Makeup&Skin Care LLC(Juarez,Isabel)
PAYMENTS
TRANSACTION NUMBER: TRC-68007164-07-07-2023
PAYMENT DATE: 07/07/2023
PAYMENT TYPE: Credit Card
307736274
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
07-23-425172 110-580200-663000 Tattoo Artist Fee 5225.00
TOTAL PAYMENTS: $225.00
FLI-07-2022-175806
CASE TYPE: Food&Lodging Institutions WORK CLASS: 61 -Tattoo Artists
SITE ADDRESS: 2820 16TH ST NE,HICKORY NC 28601
Applicant INJ BEAUTY MAKEUP&SKIN CARE LLC,2820 I6TH ST NE SUITE I,HICKORY NC 28601
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 07/07/2023 12:45 Page 1 of 1