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Home My WebLink AboutEHPR-08-2022-42105.tif ENVIRONMENTAL HEALTH Catawba County Government Center 25 Government Drive I P.O. Box 389 I Newton, NC 28658 catawba county Phone: (828) 465-8270 Fax: (828) 465-8276 public bean •uiNG LIVING.HIH2 Email: EIA Irui. . '.. 6141)i-2_, L) VC%(y) uS Food Establishment Plan Review Application foi uwileiship Change (Note:If the establishment has been closed for more than one year, then applicant must fill out short form instead of this form) Name of Existing Establishment: t h6f14 S r-R Name of New Establishment: U S I t( - C4-4j ell I,- Establishment's Address: �� l] \ inQ-44-i ` `a City: ( -t.Jbt-) State: NC- ZIP: a 8G, 0 5 Phone: 7 0 Li 7`15 C(v&' D. Fax: 70 / '7 a U l!v 0 New Owner's Name( 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 1/4" =1') showing location of equipment,plumbing, electrical 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 Number of Seats: Sun cP - Maximum Number of Staff per Shift: le Mon l Lb5 +e� Facility Total Square Feet: Tue �P a Wed to °f' Projeded Start Date: C )i 3 at) Thu (o Fri CD - 36/M Projected Number of Meals to be Served (Approximate number): Sat - Breakfast 10 ° Lunch (D 0 Dinner In 6 BREAKFAST 6:00AM TO 10:30AM PLATES SERVED WITH: GRITS,RICE OR GRAVY EGGS YOUR WAY WITH BACON,SAUSAGE, LIVERMUSH OR BOLOGNA WITH LINK SAUSAGE WITH FULL PIECE OF COUNTRY HAM WITH ONE/HALF PICE OF COUNTRY HAM OMELETS SERVED WITH:GRITS,RICE,OR GRAVY,BISCUIT OR TOAST(HOME FRIES$1.00 MORE) WESTERN(ONIONS/PEPPERS/HAM/TOMATOES/CHEESE) HAM AND CHEESE BACON AND CHEESE VEGGIE(ONIONS/PEPPERS/TOMATOES/CHEESE/MUSHROOM) CHEESE SANDWICHES BISCUIT, BUN OR TOAST EGG BACON,SAUSAGE, LOVERMUSH, BOLOGNA BACON, LETTUCE,TOMATO,AND MAYO COUNTRY HAM PANCAKE/WAFFLES SINGLE PANCAKE 3 STACK PANCAKE FRENCH TOAST GRAVY BISCUITS 1 BISCUIT WITH GRAVY 2 BISCUIT WITH GRAVY SIDES BACON,LIVERMUSH,SAUSAGE, BOLOGNA LINK SAUSAGE FULL SLICE COUNTRY HAM 1/2 SLICE COUNTRY HGAM GRITS WITH GRAVY HASHBROWN DRINKS SOFT DRINKS(PEPSI PRODUTS) TEA(SWEENTED AND UNSWEETENDED) COFFEE MILK ORANGE JUICE/APPLE JUICE DESSERT OF THE DAY CONSUMING RAW OR UNDERCOOKED MEATS,POULTRY,SEAFOOD,SHEEFISH OR EGGS MAY INCREASE YOUR RISK OF FOODBORNE ILLINESS,ESPECIALLY IF YOU HAVE CERTAIN MEDICAL CONDITIONS LUNCH 11AM TO 2PM LUNCH PLATES MEAT/1 VEGETABLE MEAT/2 VEGETABLES MEAT/3 VEGETABLES VEGETABLE PLATE (3) EXTRA VEGETABLE BOWL OF PINTOS WITH CORNBREAD AND ONIONS SALADS HOUSE SALAD CHEF SALAD SIDE SALAD DRESSING: RANCH FRENCHG ITALIAN BLUE CHEESE THOUSAND ISLAND SANDWICHES TOPPINGS: SLAW MUSTAND CHILLI ONIONS OR LETTUCE TOMATO ONION MUSTARD MAYO EGG SALAD CHICKEN SALAD GRILLED PIMENTO CHEESE GRILLED CHEESE GRILLED HAM AND CHEESE PAT'S PLACE BURGER(8 OZ BURGER) HAMBURGER(ANY TOPPINGS) DOUBLE HAMBURGER(ANY TOPPINGS) CHEESEBURGER(ANY TOPPINGS) DOUBLE CHEESEBURGER(ANY TOPPINGS) HOT DOG (ANY TOPPINGS) PHILLY CHEESESTEAD PHILLY CHICKEN BLT SIDES FRENCH FRIES TATER TOTS ONION RINGS DRINKS SOFT DRINKS(PEPSI PRODUTS) TEA(SWEENTED AND UNSWEETENDED) COFFEE MILK ORANGE JUICE/APPLE JUICE DESSERT OF THE DAY CONSUMING RAW OR UNDERCOOKED MEATS,POULTRY,SEAFOOD,SHEEFISH OR EGGS MAY INCREASE YOUR RISK OF FOODBORNE ILLINESS,ESPECIALLY IF YOU HAVE CERTAIN MEDICAL CONDITIONS Friday Night Catfish Flounder Shrimp Chicken Tender Hamburger Steak French fries Onion Rings Tater Sauce Slaw Baked Beans ,.,/0•00"1" , • .... , .., 4441.itelk ' 1. .,'': -:.-v',',• .... 1 .2106.1111r .4p, • ,ialigastali?' .- , -3.,;04 iiii ik„, .:- 'tt-',. .-..,,„ !ftx,Illr-l'il,Vil(41J-'•,,,it,•,',..I4'.'xPz';; ..,-,'' :.\ . — '- t•','. ' ''' ' -' '''''.' ' '''''''*''''';'''';;,'It: ,;- A ....teimeallharsammess... • -.•'''' -- laserier •. ,,,, . o• ----41,041lems" '44''' . --. voisterthiet --..4.• - --. • -.. , 0.4* 1 1 4. ..rosoolm 4,41,Pr"..44,141r#.-, i • ,.t''' ..i4• ' t l i 1 k .. - -..*:'' "45;,,,,lh- •, : '71'''... "' '; ,-6,*;,,,,-; 4:!,.',„:'z:',.`"...,.., •I :-..,.7...' , ' ' 1 .-- ,,,,,:,..,,,,,.:.; 't.`.,..;•s'itA,t.••-,,,'''• '''.,c-• ,. • , , ,s,....y.,e•::?,,..- ,:'-.- -,,i;:'-'''''...`...'''' '" ' 7'''''''' '.‘ ;.:-•,,..":,•.. ,'. - . . . Note: Food pans sold separately *,- 1 Only $1,219.00/Each 4 interest-free payments of$304.75 Prequalify ) 0 CREDIT KEY Discounted shipping with Available in Scratch&Dent for $975.20> What We Offer Protect Your Product- Loverage starting at 1)41.4u WI 0 • Earn up to$36.57 back(3.657 points) �rU with a Webstaurant Rewards Vk ' It C d Wish List w 1 ! Rapid Reorder Other Available Types: 'iv" ?iii 2( ;._4O' Three Pan/120V Two Pan/120V Four Pan/120V Four Pan/208/240V J Medium-duty stainless steel and galvanized leg construction, ensuring durability and reliability d 8" deep wells hold 5 full size food pans; accommodates various pan configurations for versatility d Polyethylene 8" deep cutting board provides plenty of extra work space d Convenient undershelf provides additional space for utensils, pans, or lids ✓ Independent infinite control knobs for optimum heating versatility V Pans sold separately Quality Rating: UPC Code: 40001426395 , Quick Shipping , • Usually ships in 1 business day A , . .. ... . . .. --,;„ -.• - - .' ' :.:',.,f": . '',.'-:-:', •-•,• -..,,, ,--;4 :- / ' ':..1:: '''-''''''''' ''...''''•''' ' 'e.• _., .• „... ,. -. , --.'. • - . .. , , -,,..,.. ,- ,„..-„;. ,•. - . .• i4--,;•. . . . . ,,. . .. . , ',, , -.....„......... ..- t ... ., . ,...--- .., • . •,.... - - . - , , ., '''.-: ----—7,—, -----'-='-'-. 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'f;'''' ,..;''.',.,V.' • ': ,. r- '' r''': l.:7;1''',.;,,rOt14,111,1VA'',1'''. - * l* 1.00d 4.,:i'^-.....,...„, P . , •,,,,i..4,---, m: , t, ‘,.• , . ......„--,4 , >You last purchased this on Dec 01 2021 at 04:06AM EST c-r,,,;(‘- shippirict 6 Only $89.99/Each Ships free with What We Offer IC) Protect Your Product Coverage starting at$18.75 0 Arid Protection 1 Add to Cart Wish List•• Rapid Reorder Customers Also Viewed Servlt FW150 12"x 20"Full Size Electric Countertop Food Cooker/Warmer with Digital Controls-120V,1500W $129.99/Each 1 Aii4 t.Cart V Maintains food safe temperatures for hours d Durable stainless steel food well d Holds a full size 12" x 20"food pan or fractional size food pans(sold separately) ./ Heating element supports direct heat to food ,/ 120V,1200W Quality Rating: UPC Code: 64656340085c, .,,1G. Quick Shipping • • Usually ships in 1 business day 0 EQUIPMENT VAIVTCO View all Avantco Equipment Countertop Food Warmers Works With 0 CATAWBA COUNTY t5'/� 111\1\ 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT PHONE: 828.465.8399 Monday,August 29,2022 1 g 4 2 5M www.catawbacountync.gov PAYOR: Parker,Patricia E PAYMENTS TRANSACTION NUMBER: TRC-46219428-29-08-2022 PAYMENT DATE: 08/29/2022 PAYMENT TYPE: Credit Card 294374368 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 08-22-411243 110-580200-663000 Food and Lodging Review Fee $75.00 TOTAL PAYMENTS: $75.00 EHPR-08-2022-42 1 05 CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI SITE ADDRESS: 110 S MAIN ST,CATAWBA NC 28609 Applicant RUSTIC RAIL, 110 S MAIN ST,CATAWBA NC 28609 Paid By PATRICIA E PARKER,93 ARLIE LOOP,STATESVILLE NC 28677 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 08/29/2022 13:03 Page 1 of 1