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Home My WebLink About60 Bidwell Road (3) Town of South Windsor - Health Department Q1540 Sullivan Ave., South Windsor, CT 06074- Mailing Address y 1530 Sullivan Avenue South Windsor CT 06074- Office Address Phone Number: (860) 337-6173 Fax: (860) 644-1930 1QSOR.Co Restaurant Establishment Information New Permit❑ Permit Renewal [� ***(Please Print Clearly)*** Name of Establishment: Xew/c�,u►-'s ' J :��/ice ,'✓Er CC��y Manager's Name: W&Ara-1 Street Address: City, State, Zip Code: Si:�fh �vrnC CT ao 7y Phone#: (f(OC) 2 5& -/1077 Cell Phone#: Fax#: go E-Mail Address: Seating Capacity: SO -f Please submit latest copy of the Qualified Food Operator/ServSafe certificates to the office. Qualified Food Operator: YES[(NO ❑ (Required for Certificate#: Class 3&4) ! Name: c�h.yern_ Date: /V g/C Testing Organization: evv Sc� Phone#: i O -SOc2 -S i67S E-Mail Address: !e • �5 y%gj,,, Alternate Phone#: g(U - I5 p // T.:4 Designated Alternate 1: n Designated Alternate2 Restaurant Owner Contact Information Owner's Name: Street Address: ��C) ��r1 5� City, State, Zip Code: CTi 666)71 Phone#: Fax #: E-Mail Address: �C��, sa �l c Cell Phone#: 5�oc QS-2-7-T-0c•j Renovations Were there any renovations made last year? YES❑ NO [�j Will there be any renovations? YES❑ NO If Yes, please list all renovations that were done/to be done: Mailing Address to send Food License Renewal Permit to: Name of Restaurant/Company: Attention: /mac/i; !�� .�//s RECEIVED Address: City, State, Zip Code: ��f �t/i, /sc,� c �7- l��vp�y PlEU i j Ali I Phone#: 190 -// 7p �i SOUTH ()b77� CL-JI �S Ta�� HEALTHH D DEPEBT., Restaurant Menu/List of All Items Served/Sold Latest Menu Attached? YES[/ NO ❑ N0TE••(N1ust have latest copy on file) Please list all menu items in as much detail as possible or a copy of a menu attached is applicable. Additional Information Please check one only: State Licenses: ❑ akery [ Liquor Permit ❑ None Water Supply: Public Private Well Wastewater Disposal: /Public On-Site _Other(please use space below to explain) Agreement and Signature By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that any false statements or other misrepresentations made on this application may result in immediate shutdown or revocation of my Food Service License for the Town of South Windsor. Applicant Name (Print): Applicant Signature: / Date: Office Use Only Inspector Name (Print): Inspector Signature: M Date: Food Class: 1 ❑ 2 ❑ 3 [q"' 4 ❑ Expiration Date: I ZJ3NI g Date Received: Date Approved: r a ten enders Loaded frie crispy chicken tender strips 7 Comes with side of sour cream and salsa 9 Add chili 10 Layered Nacho Dip Salsa,sour cream.taco meat,refried Chips and Salsa beans and sharp cheddar cheese baked Corn tortilla chips served with fresh house in a casserole Served with a basket of salsa 5 fresh chips 9 Mozzarella Triangles Revolutions Sampler Platter Breaded mozzarella wedges fried to a crisp Chicken tenders,stuffed potato skins, with our homemade mannara sauce 9 mozzarella triangles and onion rings. Sure to please everyone 14 Buffalo Chicken Dip Grilled chicken combined with hot sauce. Onion Ring Tower blue cheese dressing.cream cheese and Thick sliced and breaded Served golden cheddar jack cheese Served with tortilla brown with homemade ranch and our chips 11 secret sauce 7 Chili Loaded Nacho Platter Spinach' p _ Crisp corn tortillas topped with bacon A creamy m . ichoke and green onion,jalapeno peppers.black Monterey ja n cheeses olives cheddar jack cheese and chili 10 baked into a beautiful bubbly blend with tortilla chips 8 Fried Calamari With lemon and a cherry pepper aioli 9 Southwest Eggrolls Smoked chicken black beans,corn. Revolutions Wings jalapeno jack cheese.red peppers and Mild, Hot BBQ,Spicy BBC,Honey Hot. spinach wrapped inside a crispy flour Sweet Teriyaki Garlic Parmesan.Sweet tortilla with avocado ranch d•ip.9 Red Chili or Mango Habanero Dry Seasoned Ranch.Garlic or Southwest Stuffed Potato Skins BBQ Served with carrots and celery Golden brown potato skins filled with sticks.ranch or blue cheese dip. Monterey jack and cheddar cheeses Traditional:six for 8, twelve for 14 freshly crumbled bacon and fresh chives. Boneless: 1/2 lb for 8,one lb for 14 Served with sour cream 8 Beef Empanadas Jerk Chicken Sliders Seasoned beef baked in a crispy dough Grilled chicken.lettuce,tomato. shell drizzled with cilantro aioli.7 provolone cheese and a sweet and spicy jerk marinade 10 BBQ French Fries With spicy ketchup 5 Colossal Pretzel Served with mustard and a cheese Beef Sliders` sauce 10 I With cheddar cheese,caramelized onions and house made Fried Pickles Served with southwestern ranch 8 I I evolufions douse Salad Chicken Caesar Salad Mixed greens,grape tomatoes,shaved Fresh crisp romaine lettuce tossed with red onion,fresh pear slices,candied our own Caesar dressing.Topped with pecans,blue cheese crumbles and fresh fresh croutons,shaved Parmesan and made croutons.Topped with our own grilled chicken breast. 10 Dijon Vinaigrette 9 Add Grilled Chicken 3 Cobb Salad Mixed greens served with diced tomatoes black olives hardboiled egg.bleu cheese crumbles bacon and avocado Topped with grilled chicken breast 12 Dressings:Parmesan Peppercorn. Caesar. Blue Cheese. Ranch Golden Italian or Balsamic Vinaigrette 1 Consuming raw or undercooked meal poultry shellfish or eygs may increase your risk of foodborne illness Please notify your server of any food allergies when you order r ■ .■■ ■ _ - r V231r, AZZ7 �.%V g qp or Ir Alm 1 0 1h - f No - - ■ r ■ .� ■� - Fmq I OW dL �• ram' r ■ t 7 r WVQ • too. ME wo <$ L Ll r • ' ■ nip LL • • a • a • AP •N a , All Paninis are with f ps Substitute onion rings,sweet. fries or wa fries for 2 00 Grilled 3 Cheese Tomato and Pesto Cheddar Provolone and Parmesan cheeses 9 ream Steak and Cheese sil shaved Parmesan and mozzarella 9 Shaved steak with peppers.onions and American cheese 11 &Spicy Chicken Flatbread Grilled chicken,roasted red peppers,green Grilled Chicken BLT onion,mozzarella cheese,honey hot sauce 11 With basil aioli 10 Honey BBQ Crisp fried chicken,cheddar cheese ranch bacon and honey BBQ 10 99 1 Personal 16 inch Cheese Home made pizza sauce topped with shredded mozzarella cheese 8 16 Vegetarian Red pizza topped with onion.peppers.mushrooms,sliced tomato and mozzarella. 12 20 Sausage&Pepper Red pizza lopped with sweet bits of Italian sausage and peppers with grated cheese. 12 20 Tomato Pesto Fresh basil pesto spread over a layer of cheese topped with fresh tomato slices roasted garlic cloves.EVOO and grated Romano 12 20 Buffalo Chicken Breaded chicken cutlet tossed in a spicy wing sauce Topped with mozzarella and drizzled with blue cheese dressing 12 20 Potato Bacon Cheddar Sliced red potatoes fresh grated cheddar,bacon crumbles.caramelized onions and sour cream An Irish take on pizza 12 BBQ Chicken Grilled chicken breast,tanSLE1,BQ sauce and mozzarella cheese cherry peppers.artichoke mato 1 00 each Gorgonzola 2 00 Chicken,Pepperoni.Hamburger or Sausage 2.50 Consuming raw or undercooked meal,poultry shellfish or eggs may increase your risk of foodborne illness alder hen you order 'T 1 1 I ■ ' r ■111 ■ I ti ti r� � ■ i. "J 1 m 1 1 r ' 1� ■ >, IM �1 F' ti � � qr � � i III Pf Ak - 4 r- 1 1 - r` 1 EJF 'w - + , I r' Mir 1 1 ■ r EL 1 Y r IN ■ I 1 x x Ad, mr oaf�..�. A _aall l FOO UN 1 , & 7 days a week n1,ijdes a $10.00 game card and meal $17,99 MEAL CHOICES; • Rev's Burger •Chicken Caesar Salad • Personal Pizza with choice of two toppings •BBQ Chicken Sandwich * Buffalo Chicken Wrap *Grilled 3-Cheese Panini REV IT UPS Get any meal above plus double the • points on a game card for $24.99 -0"-ed � Z Offer subject to change. May not be combined with any other offers. Blackout days and some restrictions may apply. Does not include drinks,tax or service fees. I I rr -1 7 F T r 'f 1 �� ■ _'� ■' 1 F ■ YVAN- F Irt � I _ 1 16- 4 1 I F>• I y w J :• J 1 �r�+� r ,�I 1. �� - r ■ III � '.� PL IN `I - I 1 i ERrfFffiD of FoOV SSte! F�DS.gF��A{gNgG alb` •. c i�F I) DAIVA E LA v " Genf cerc N0,,