HomeMy WebLinkAbout515 BROADWAY STINVOICE DATE
DUE DATE
INVOICE #
TOTAL DUE
05/02/2024
06/10/2024
2024-00000323
$80.00
Customer #: 20953
KWIK STOP #4
515 BROADWAY ST
WATERLOO, IA 50703
Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
715 Mulberry St
WATERLOO, IA 50703
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION - 515 BROADWAY ST - 4-8-24
[ Description
FOR BILLING INQUIRY: (319)291-4323
INSPECTION 2,000
OCCUPANCY FEE
Total Price ]
$70.00
$10.00
CUSTOMER #
BILLING DATE
DUE DATE
INVOICE #
CHARGES
20953
05/02/2024
06/10/2024
2024-00000323
$80.00
Less Prepayment
Total Due -*
City of Waterloo
$0.00
$80.00
Failure to pay in full debts listed herein within ninety days of the due date will result in an additional twenty-five percent
late fee applied to any outstanding balance. The delinquent account will be forwarded to Municipal Collections of
America for further collection efforts. Debts shall also be subject to collection through the Iowa Department of
Administrative Services Offset Program if not paid in full within ninety days.
WATERLOO FIRE RESCUE
INSPECTION REPORT
KWIKSTOP 4, 515 BROADWAYST, BLDG 515 BROADWAYST, WATERLOO /A 50703
DETAILS
Inspection Date: 04/08/2024 1 Inspection Type: Annual Inspection (1Yr nspecti.n Number: 10054 Shift: N/A 1 Station: N/A I
Unit: N/A ! Lead Inspector: JEFF SIEBEL 1 Other Inspectors: N/A F
VIOLATIONS AND COMPLIANCES
Showing only violations and images for this inspection. Please reach out to the lead inspector for more details.
Resolved Violations: 0 I Passed Codes: 30 I Violations: 1 I N/A Codes: 42
STATUS CODE DESCRIPTION
FAIL 603.5.3 - Installation. Relocatable power tap cords shall not extend through walls, ceilings, floors,
under doors or floor coverings, or be subject to environmental or physical
damage.
Location: behind ATM
Original Comment: power strip must be properly supported and not hanging by
cords.
GENERAL NOTES
JEFF SIEBEL - 04/10/2024 @ 14:42 annual inspection $80
REINSPECTION DATE
04/29/2024
CONTACT SIGNATURE
Mohammad Sarwat
Signed on: 04/10/2024 @ 14:43
Printed on 04/10/2024 @ 15:13
Page 1 of 2
INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on: 04/10/2024 @ 14:43
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 04/10/2024 @ 15:13
Page 2 of 2