Loading...
HomeMy WebLinkAboutEHPR-03-2016-23386.TIF b-tp---- e-o3-zcxo-rzia, ,,s64 '.'fi� Catawba County Public Health Department N 'fPgQ Division of Environmental Health Y4 J:a FOOD ESTABLISHMENT PLAN REVIEW APPLICATION FOR OWNERSHIP CHANGE (Note that if the establishment has been closed for over one year then applicant must fill out short form instead of this form) Name of Existing Establishment: l L L.y 8 /E CS Name of New Establishment Unless the Same: Z O R 134 Establishment's Address: 929 C 0 M o v car. /3 L I/ w ' City: Co N O VC/1-- Zip Code: New Owner's Name: E Ll 4J u r¢P M°S Mailing Address: Q o g S f j-t p w co c PL City:M_o 4 A o✓Zip Code: a g 4 f Phone Number: ) -(!f 6 I -,Se(6 Fax: ( wn..n*n_nwnn:.e*r4*.,rnr nnw**4**i******.*************rnrwv.rttv.rx*xA******n****r*t .********************“* Please Enclose the Following Documents • Proposed menu items (including seasonal variations in the menu). • Manufacturer specification sheets for each piece of equipment that may be added or replaced. • Plan of facility drawn to scale (min ''A" = 1') showing location of equipment, plumbing, electrical P' service and mechanical ventilation, including location of all electrical panels only if complete remodel and/or replacing, adding/moving equipment. That will be determined by plan reviewer. Hours of Operation Sun //- /0 Mon //— /0Tue //- /o wed 11• /° Thu //- /0 Fri /1- (0 Sat /(• /t Number of Seats /6 Number of Staff ZJ (Maximum per shift) Facility Total Sq. Ft. Projected Number of Meals to be Served: (Approximate number) Breakfast Lunch ✓ Dinner Projected Start Date: if- Ain a t /‘ Type of Service (Check all that apply) Sit Down Meals ., Take Out Caterer Mobile Food Unit tJ a Push Cart ti D Limited Food Service Single Service Utensil Only Multi-Use Utensil Service Only Other ITEMS THAT NEED TO BE ADDRESSED 1. Information plans should include; the proposed menu, seating capacity, projected daily meal volume for food service operation. 2. Adequate rapid cooling including ice baths and refrigeration, and hot-holding facilities for potentially hazardous food (PHF) should be clearly designated on the plan. 3. When menu dictates, separate food preparation sinks should be labeled and located to preclude contamination and cross-contamination of raw and ready to eat foods. 4. Auxiliary areas such as storage rooms, garbage rooms, toilets, basements and/or cellars used for storage or food preparation should be represented on a plan. 5. Insure that all food service/kitchen equipment is National Sanitation Foundation International (NSF) listed, Underwriters Laboratories Inc., Classified for Sanitation or if not NSF or UL listed/classified, be constructed to meet NSF/ANSI standards as specified according to I5A NCAC 18A .2600, Rule .2654 and 2009 NC Food Code Manual Chapter 4. 6. As specified according to 2009 NC Food Code Manual 4-4 all items stored in rooms where food or single-service items are stored shall be at least 6 in. (15.24 cm.) above the floor when placed on stationary storage units or when placed on portable storage units or otherwise arranged so as to permit thorough cleaning. FINISH SCHEDULE Floor,wall and ceiling finishes(vinyl tile,acoustic tile,vinyl baseboards,FRP,etc.} AREA FLOOR BASE WALLS CEILING l Kitchen Bar Food Storage Dry Storage Restrooms Garbage& Can Wash Areas - Wait Station Areas Other - • Other 2 1 FOOD PREPARATION REVIEW Check categories of Potentially Hazardous Food (PI-IF) to be handled prepared and served. CATEGORY Yes No Thin meats, poultry, fish, eggs (hamburgers, chicken breast, fish filet, etc.) 1/4J _ Thick meats, whole poultry (whole roasts, pork, chicken, meat loaf, etc.) Hot processed foods (soups, stews, chowders, casseroles) '✓ Bakery goods (pies, custards, creams) V Other: PLEASE CHECK BOX FOR THE FOLLOWING QUESTIONS FOOD SUPPLIES 1. Are all food supplies from inspected and approved sources? Yes 'I No COLD STORAGE ?. Are adequate and approved freezer and refrigeration available to store frozen foods at 00 F and below, and refrigerated foods at 45° F (70 C) and below? Yes tJ No Provide the method used to calculate cold storage requirements: Provide total footage of space dedicated to walk-in cold storage Provide total footage of space dedicated to reach-in cold storage 3. Will raw meats, poultry and seafood be stored in the same refrigerators and freezer with cooked/ready-to-eat foods? Yes # No V If yes, how will cross-contamination be prevented? 4. Does each refrigerator/freezer have a thermometer? Yes I/ No Number of refrigeration units: ! Number of freezer units: 2 THAWING Please indicate by checking the appropriate box how PI-IF (potentially hazardous food) in each category will be thawed. More than one method may apply. Thawing Process Thick Meats Thin Meats Fish Seafood Poultry Products Baked Goods Refrigeration Running Water less than 70°F(2I°C) .X /.71: _._ • _ Cooked Frozen(indicate wt. lbs.) Microwave ) Other (describe): 3 COOKING PROCESS Item #1 - Will food product thermometers (0°—212° F) be used to measure final cooking/reheating temperatures of PHF (potentially hazardous food)? Yes •C No Minimum cooking time and temperature of product utilizing convection and conduction heating equipment: Product Time &Temperature Product Time & Temperature Beef roast 130° F (121 min) Comminuted meats 155°F (15 sec) Seafood 145° F (15 sec) Poultry 165° F (15 sec) Pork 155°F (15 sec) Other PHF _ 145° F (15 sec) E•gs 145° F (15 sec' * reheating PHF 165° F (15 sec) Item #2 - Hot Holding How will hot PHF (potentially hazardous food) be maintained at 135° F (60° C) or above during holding for service? Indicate type and number of hot holding units. Item #3 - Cold Holding How will cold PHF (potentially hazardous food) be maintained at 45° F (7° C) or below during holding for service? Indicate type and number of cold holding units. 4 Item #4- Cooling Please indicate by checking the appropriate box how PHF (potentially hazardous food) will be cooled to 45° F (7° C)within 6 hours (135° F to 70° F in 2 hours and 70° F to 45° F in 4 hours). Cooling Process Thick Meats Thin Meats Fish Seafood Poultry Products Baked Goods Shallow Pans -• •_ _ Ice Baths X - . - - Rapid Chill Other(describe): 4 FOOD PREPARATION 1. Please list categories of food prepared more than 12 hours in advance of service. TOwA-r a c ce Q,ZZa 4,o..2 �y 2. Will disposable gloves and/or utensils and/or food grade paper be used to minimize handling of ready-to-eat foods? Yes K No 3. Is there an established polity to exclude or restrict food workers who are sick or have infected cuts and lesions? Yes No Please describe procedure: P OT A Li-a W -ta W o 1-tr. 4. How will cooking equipment, cutting boards, counter tops and other food contact surfaces which cannot be submerged in sinks or put through a dishwasher be cleaned and sanitized? Please describe procedure: 'W t L� f,& I (-p't P Jo S tz t 2E f7 5. How will ingredients for cold ready-to-eat foods such as tuna, mayonnaise and eggs for salads and sandwiches be pre-chilled before mixed and/or assembled? V �Eof e ritpart • 6. In_d1icate any specialized process that will take place: 1°0 Curing 00Acidification (sushi, etc.) , O Smoking Reduced Oxygen Packaging (e.g. vacuum packaging, sous vide; cook-chill, etc.) Explain checked processes: 5 • THE FOLLOWING 4 QUESTIONS DEAL WITII FOOD PREPARATION PROCEDURES FOR FACILITIES. Food preparation procedures are needed to obtain information on how the food is prepared and to help determine that adequate facilities are available. The food preparation procedures should include types offood prepared, time of day and equipment used for service in the facility. (Attached is Food Item Preparation Worksheet Supplement for additional food items prepared in the facility.) If your company has food preparation procedures already developed, these can be submitted as part of the plan review approval process. 1. Produce Preparation Procedures a. Will produce he washed or rinsed prior to use? Yes J No b. Is there an approved location used for washing or rinsing produce? Yes No c, Will it be used for other operations? Yes_ No V Please indicate location of produce washing equipment and describe the procedures. Include time of day and frequency for washing or rinsing the produce at this location: ( 4J to Jas 4 lA ( b LQn u Cfl knS- GL4a t (^ Please describe the produce preparation procedures and indicate location of equipment to support this operation. The preparation procedure should include dishes (proposed menu items) in which the produce will be used, and should include time of day and frequency of preparation for the produce at this location: 5P- oc l c-va- , t,/6 2. Seafood Preparation Procedures a. Will seafood be washed or rinsed prior to use? Yes d No b. Is there an approved location used for washing or rinsing seafood? Yes J No c. Will it be used for other operations? Yes No Please indicate location of seafood washing equipment and describe the procedures. Include time of day and frequency for washing or rinsing the seafood at this location: 5� w 't.-t., L LA W fa C EdL tt aSt�lr tr P t� i Ce 6 Please describe the seafood preparation procedures and indicate location of equipment to support this operation. The preparation procedure should include dishes (proposed menu items) in which the seafood will be used, and should include time of day and frequency of preparation for the seafood at this location: 3. Poultry Preparation Procedures a. Will poultry be washed or rinsed prior to use? Yes tj No b. Is there an approved location used for washing or rinsing poultry? Yes V No c. Will it be used for other operations? Yes No L/ Please indicate location of poultry washing equipment and describe the procedures. Include time of day and frequency for washing or rinsing the seafood at this location: Please describe the poultry preparation procedures and indicate location of equipment to support this operation. The preparation procedure should include dishes (proposed menu items) in which the poultry will be used, and should include time of day and frequency of preparation for the poultry at this location: 4. Pork and/or Red Meat Preparation Procedures a. Will pork and red meats be washed or rinsed prior to use? Yes No b. Is there an approved location used for washing or rinsing pork and red meats? Yes J No c. Will it be used for other operations? Yes No ✓ Please indicate location of seafood washing equipment and describe the procedures. Include time of day and frequency for washing or rinsing the seafood at this location: Please describe the pork and red meats preparation procedures and indicate location of equipment to support this operation. The preparation procedure should include dishes (proposed menu items) in which the pork and red meats will be used, and should include time of day and frequency of preparation for the pork and red meats at this location: 7 DESIGN INFORMATION 1. DRY GOODS STORAGE I. Is appropriate dry good storage space provided for based upon menu, meals and frequency of deliveries? Yes V No Provide information on the frequency of deliveries and the expected gross volume that is to be delivered each time. P(PT X. 2a <4 SrS NI k- aS CA W(re-IA H. WATER SUPPLY 1. Please check one: Is water supply a well (community)? Yes No Municipal? Yesg No If the Water supply is other than a Municipal supply, it will be required to be registered with Public Water Supply. 2. If water supply is from a Community Water Supply system is it registered and approved as public water supply? Yes 'y. No If yes, please attach copy of written approval and/or permit. 3. Is ice made on premises or purchased commercially? Yes 'G No Please specify: \(C.. f•-■erw.. If made on premised than specification for the ice machine will need to be provided. Describe provision for ice scoop storage: III DUMPSTER 4. Will a dumpster be used? Yes V No N/A Number `)-� Size L4O- - Frequency of Pickup Contractor Service: R 'PO /3 t,/ L ,SCAQYs 5. Will the dumpster be cleaned on site? Yes ti No If the dumpster is to be cleaned on site, then the waster water from the cleaning operation will be required to be discharged to the sanitary sewer system. 8 . ' 6. Is the dumpster to be cleaned by an off site contracted cleaning service? Yes l/ No If yes, please provide name and address of the firm contracted for this service. Name: Re SO R LIC .4 ERrlGC S Mailing Address: i/ o C 2 SSCr1 o .t/ /74„)i.e_ Rociat City: i/Gto f State: N r Zip Code: a2 Co / Telephone: (82-2-( ' Fax: t/Zq )-(2 . - ) 7. Will trash containers be stored outside? Yes v No If yes, please describe location: S. Type and location of waste cooking grease storage receptacle: e t-C k o(a: T N>c (2-EN td;,.)sk.cs 9. Is there an area to store recycled containers? Yes t) No Describe: 10. Location and size of grease trap: Q(Ptc U, a r p �� . 1�4 CT da►rT X. SEWAGE DISPOSAL 1. Is building connected to a municipal sewer? Yes t/ No 2. If no, is private disposal system approved (septic system)? Yes / No Pending If yes, please attach a copy of the written approval and/or permit. ..r*,,:_...._rt,,...r.m._,wn,,..-. ...,+,c._.,x,,, r-,**t*** -,:r.:,...,....,:.._.,...,w,...,....rM,,.)..{*** *—,.,_r — STATEMENT: I hereby certify that the above information is correct, and I fully understand that any deviation from the above without prior approval from this Health Regulatory Office may nullify this approval. Signature(s) (r/103 Q/ y—Lef 1— i L Lt c 9 1 nApse_+,.~,o s Owner(s) or Responsible Representative(s) Date: .2, I k 9 es APPETIZERS • 1. Fried Calamari with our home made marinara sauce $9.99 2. Hummus Creamy hummus served with toasted pita points tomato's olive oil $5.99 3. Fresh Fried Mushroom with ranch dressing $6.99 4.Jalapeno Poppers(6)with cream cheese $6.99 5. Mozzarella Sticks(6)with our home made marinara sauce $6.99 6. Grilled Pita Bread with tzaziki sauce $3.99 7. French fries with bacon melted mozzarella cheese $4.99 ENTRÉE SALAD'S AND SOUPS 1.Garden:Crisp mixed greens,tomato, cucumber and red onion small: $3.29 Large: $4.99 2.Caesar: Fresh romaine lettuce,grated cheese, croutons served with Caesar dressing • Small:$3.29 Large: $4.99 3.Greek: House salad, Feta Kalamata olives, Pepperolhini with Greek Dressing Small:$5.99 Large: $6.99 Add grilled chicken$2.99 add salmon $3.50 4.Antipasto:Salami, ham, pepperoni, fresh mozzarella, red roasted peppers, kalamata olives, pepperoncini s on bed of house salad $7.99 • Soup of the Day: It changes every day.Just ask! Cup: $2.99 Bowl: $3.99 41110 • BURGERS Made from 100%Angus Beef 5%< Burger with lettuce, tomato with French fries $6.79 Cheeseburger with lettuce,tomato with French fries $6.99 Alpine Burger with provolone cheese, bacon,grilled onions,mushrooms,with French fries $6.99 Athenian Burger with lettuce,tomato, feta oregano with French fries $6.99 ALL BURGERS SERVED ON BRIOLU BUNS CLUB SANDWICH CHOICE OF ROAST BEEF,TURKEY,OR HAM All served on Texas toast with American cheese,Apple wood bacon, lettuce,tomato,with French fries. • $7.99 HOT SUB 8" Veal Parmigiana $8.99 Meatball $6.99 Sausage $6.99 Chicken Parmigiana $7.99 Eggplant $6.99 Pizza Steak $7.99 All above come with Homemade, marinara sauce, mozzarella cheese, baked with French fries. Grilled Chicken with peppers, onion, mozzarella cheese baked with French fries $7.99 • • COLD SUB 8" ITALIAN SALAMI, HAM, PEPPERONI, LETTUCE,TOMATO, PROVOLONE CHEESE, OIL AND VINEGAR Turkey with lettuce,tomato, provolone cheese with French fries $7.99. Roast Beef with lettuce, tomato, provolone cheese with French fries $7.99 Ham with lettuce,tomato, provolone cheese with French fries $7.99 Chicken Salad with lettuce,tomato, provolone cheese with French fries $7.99 ZORBAS SPECIAL SANDWICH Gyro(lamb) served on pita bread with lettuce,tomato, onion, and Tzatziki Sauce $7.99 Marinated Chicken Souvlaki served on pita bread with lettuce, tomato,onion, and Tzatziki sauce $7.99 Marinated Pork Souvlaki served on iota bread with lettuce,tomato;onion, and Tzatiki sauce • $7.99 Our famous Crab Cake Sandwich served with red roasted pepper sauce, lettuce,tomato, with French fries on Brioche bun $10.99 Lean Roast Beef Sandwich with American cheese, lettuce, tomato $6.50 Turkey Sandwich with American cheese, lettuce,tomato $6.50 Ham &American Cheese Sandwich with American cheese, lettuce,tomato $6.50 Chicken Salad with lettuce and tomato $6.50 OUR FAMOUS SPEGHETTI ALL PASTA 100%SEMOLINA IMPORTED FROM ITALY Served with salad and homemade bread (Greek or Caesar salad add $2.00) served with your choice of: Marinara Sauce $10.95 Special Recipe Meat Sauce & Marinara $11.95 • Homemade Meatballs& Marinara $11.95 • Imported Italian Sausage & Marinara $11.95 Mushrooms& Marinara $11.95 Baked with Cheese $1.00 or more Side order Meatball, Sausage, Mushroom $3.50 TRADITIONAL PASTA SPECIALS All of our pasta is made 100% Durham Semolina Flour all are served with salad and homemade bread (Greek, Romain, Caesar salad add$2.00) Fettuccini Alfredo$11.99 Chicken $13.99 Shrimp$14.99 Fettuccini covered with the classic butter cream and parmesan sauce Rigatoni a la Amatriciana an Italian specialty the originated in the town of Amatrice, consisting of rigatoni,fontantini sausage, ricotta cheese and marinara sauce,smothered with mozzarella cheese and baked $12.99 • Linguini with Clam Sauce (white or red) linguini with garlic, extra virgin olive oil,tender littleneck clams and mixed herbs, covered in choice or red or white sauce $12.99 Shrimp or Chicken Rigatoni a al Vodka rigatoni sautéed in extra virgin olive oil, with fresh tomatoes, onions and garlic in a creamy pink vodka sauce $14.99(shrimp&chicken $16.99) Seafood Fra Diavolo angel hair pasta, shrimp, baby sea scallops, mussels in our homemade marinara sauce $12.99 Rigatoni Carbonara tender rigatoni sautéed in Alfred sauce with imported ham, bacon,fresh mushrooms, and peas $12.99 POLIO-(CHICKEN) ALL CHICKEN ENTREES SERVED WITH HOUSE SALAD AND HOMEMADE BREAD(GREEK OR CAESAR SALAD ADD$2.00) Chicken Parmigiana with Spaghetti boneless breast of chicken lightly breaded and baked with marinara sauce,topped with melted mozzarella cheese $12.99 • Chicken Marsala with Linguine boneless breast of chicken sautéed in butter with a mushroom wine Marsala sauce $12.99 Chicken Piccata with Angel Hair boneless breast of chicken sautéed in butter with capers in lemon wine sauce $12.99 Chicken Scampi over Linguine boneless breast of chicken topped with eggplant, mozzarella and marinara sauce $12.99 SEAFOOD Served with salad and garlic bread (Greek, Romain, Caesar salad add $2.00) Ask for Daily Fresh Fish served with Vegetable Medley Our Famous Maryland (back fin)Crab Cakes $19.99 Two homemade secret recipe crab cakes, prepared fresh daily, served with choice of potato MEDITERANEAN FLAVORS GREEK SPECIALTIES Mousaka (Layers of eggplant, potatoes,ground beef,and béchamel sauce)with Greek Salad $13.99 Spinach Pie (Spinach,feta cheese, and phyllo)with Greek Salad $13.99 Souvlaki Dinner(Chunks of pork tenderloin) with lettuce, tomato, onion, feta,yogurt sauce on pita with • French fries) $13.99 Chicken Souvlaki Dinner with lettuce,tomato,onion,feta,yogurt sauce on pita with French fries$13.99 Gyro Dinner(Lamb) with lettuce,tomato,onion,feta,yogurt sauce on pita with French fries $13.99 Shrimp Santorini Dinner in a garlic tomato basil sauce with linguini topped with feta, served with a Greek Salad $15.99 STEAKS 12 OZ. Rib Eye served with choice of potato,vegetable medley, salad and homemade bread $18.99 ***Consuming Raw or Uncooked Meats, Poultry,Seafood,Shellfish,or Eggs may increase your risk of foodborne illness,especially if you have certain medical conditions. *** • GOURMET CRAFT PIZZAS GLUTEN FREE AVAILABLE IN 14"ONLY • THIN CRUST AVAILABLE IN 14" ONLY BUILD YOUR OWN PIZZA WITH OUR SPECIAL BLEND CHEESES HOMEMADE TOMATO PIZZA SAUCE Individual 10" Serves 1 $6.99 Medium 14" Serves 2-3 $9.99 Large 16" Serves 3-4 $10.99 MEAT TOPPINGS AVAILABLE Pepperoni, Fontanini Sausage, Apple Wood Smoked Bacon, Honey Ham, Canadian bacon, Anchovies, Meatballs and Extra Cheese. VEGETABLE TOPPINGS AVAILABLE Onion, Black or Green Olives, Green Peppers,Yellow Banana Peppers,Jalapeno Peppers, Fresh Mushrooms, Diced Tomatoes, Pineapple, Spinach,Garlic, Roasted Red Peppers. 10" 1.00 per topping • 14" 1.50 per topping 16"2.00 per topping • • STROMBOLI Plain with sauce and cheese Small $7.99 Large$10.99 Steak with pepper and onions Small$9.99 Large$13.99 Special (pepperoni, sausage, mushrooms, onion) Small $9.99 Large$13.99 CALZONES Ricota's House Blend Cheese with Calzones(Sauce on side) Plain Small$8.99 Large$12.99 Steak with pepper and onions Small$9.99 Large$13.99 Special (pepperoni, sausage, mushrooms,onion) Small$9.99 Large$13.99 SPECIAL PIZZAS 1.Greek Pizza olive oil,tomatoes, red onion, Gyro meat, black olives, Feta's and Tzaziki sauce swirl. Small: $13.99 Medium:$16.99 Large: $19.99 2.Artichoke Pizza Artichoke hearts, sliced tomatoes, spinach, mushrooms, red roasted peppers. Small: $11.99 Medium: $16.99 Large: $19.99 3. Mediterranean Pizza Pizza sauce with Feta's mozzarella cheese, spinach, black olives, sundried tomatoes pesto swirl. Small:$13.99 Medium: $17.99 Large: $20.99 4. Marencio Pizza Sautéed chicken in pink vodka sauce,fresh mushrooms, spinach. Small: $13.99 Medium: $17.99 Large: $20.99 5. Buffalo Chicken Pizza Spicy Buffalo mild sauce, tender chicken, red onion, mozzarella cheese. Small: $13.99 Medium: $17.99 Large: $20.99 6. Chicken Aifredo's Spinach Pizza Grilled chicken with fresh baby spinach, tomato with creamy Alfredo sauce, house blend cheese. Small: $13.99 Medium: $17.99 Large: $20.99 SPECIALITY PIZZA 1.Jorbas Special Pepperoni, onion,green pepper, mushroom,ground beef, Fontanini sauce. Small: $13.99 Medium: $18.99 Large: $21.99 2. Meat Lover's Pepperoni, ham, Fontanini sausage, bacon,ground beef. Small: $13.99 Medium: $16.99 Large: $18.99 3. Meatball Pizza Homemade meatballs, fresh basil, with special house blend cheese. Small:$9.99 Medium: $13.99 Large: $15.99 4. Hawaiian Pizza Honey ham and pineapple. Small:$9.99 Medium: $13.99 Large: $15.99 5. Fresh Vegetable Pizza Fresh mushroom,spinach, sundried tomatoes, red roasted peppers, onions, tomatoes. Small: $9.99 Medium: $16.99 Large: $18.99 6. White Pizza Roasted garlic vicotta, fresh basil house blend cheese. No sauce. Small:$10.99 Medium: $14.99 Large: $18.99 7. Margarita Pizza Pizza Sauce,fresh mozzarella,tomatoes, fresh basil, roasted garlic. Small:$10.99 Medium:$14.99 Large: $18.99 Specialty Cheese Fresh Mozzarella Vokan Cheese Feta Blue Cheese OVEN BAKED SPECIALTIES All Served with salad and bread (Greek or Caesar salad add $2.00) Lasagna Layers of tender pasta with a blend of four cheese and our special homemade sauce $12.99 Baked Manicotti Manicotti stuffed with ricotta cheese, baked in a tomato sauce and melted with mozzarella cheese. $11.99 Cheese Ravioli Large cheese stuffed ravioli, baked with a tomato sauce and melted mozzarella cheese. • $11.99 • Eggplant Parmigiana Breaded fried eggplant, baked with mozzarella cheese and marinara sauce $11.99 Veal Parmigiana Tender veal baked and topped with parmesan cheese and marinara sauce $14.99 ORIGINAL BUFFALO WINGS Choice of Mild, Medium, Hot, Boiling Hot,Jamaican Jerk, BBQ,Teriyaki, Wild Asian, Lemon Pepper Served with Celery and choice of Ranch or Blue Cheese Dressing Double Baked Wings will be an extra charge as the following 10-1.00 25-1.25 50 and up- 1.50 more 5 $5.25 10...............................$9.9 9 15 $14.50 25 $18.99 50 $42.99 75 $52.99 • 100 $72.99 Extra Dressing.........$1.00 each 20 oz. ......$8.00 Extra Wing Sauce 20 oz. $8.00 KID'S MENU Spaghetti with Meatball or meat sauce $5.99 Chicken Tent with French Fries $5.99 Cheeseburger with French Fries $5.99 Fettuccini Alfredo $6.99 • �yp� CATAWBA COUNTY � 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT a► PHONE: 828.465.8399 U " . ®<y sc.' Monday, March 14, 2016 is 4 www.catawbacountync.gov PAYOR: Zorba Zorba(Dimarhos, Elias) PAYMENTS TRANSACTION NUMBER: TRC-637142-14-03-2016 PAYMENT DATE : 03/14/2016 PAYMENT TYPE: Cash INVOICE NUMBER FEE NAME FEE AMOUNT 03-16-326112 Food and Lodging Review Fee $75.00 TOTAL PAYMENTS : $75.00 EHPR-03-2016-23386 CASE TYPE: Environmental Health Plan Review WORK CLASS: Other ELI SITE ADDRESS: 924 CONOVER BLVD W, CONOVER NC 28613 Applicant ZORBA,208 SHERWOOD PL, MORGANTON NC 28655 C:8284615467 **NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 03/14/2016 10:40 Page 1 of 1