HomeMy WebLinkAbout1830 E SHAULIS RD INVOICE DATE DUE DATE INVOICE# TOTAL DUE
/471�1�,r.:; 05/02/2023 06/05/2023 2023-00011256 $80.00
c?1€41c70 �o
Customer#: 13948 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
SOUTH HILLS GOLF COURSE 715 Mulberry St
1830 E SHAULIS RD WATERLOO, IA 50703
WATERLOO, IA 50702
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 1830 E SHAULIS RD -4-4-23 FOR BILLING INQUIRY: (319)291-4323
LDescription Total Price J
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
13948 05/02/2023 06/05/2023 2023-00011256 $80.00
Less Prepayment $0.00
Total Due— $80.00
City of Waterloo
�ptERLpO
WATERLOO FIRE RESCUE 7411\-i
INSPECTION REPORT
SOUTH HILLS GOLF COURSE,1830 E SHAULIS RD,BLDG 1830 E SHAULIS RD,WATERLOO/A
50701 4410
DETAILS
Inspection Date:04/04/2023 Inspection Type:Annual Inspection(1Yr) j Inspection Number:7674 I Shift: N/A Station: N/A j
Unit: N/A I Lead Inspector:JEFF SIEBEL I Other Inspectors: N/A
VIOLATIONS
No Violations Found
GENERAL NOTES
JEFF SIEBEL-04/05/2023 @ 08:27 Annual inspection fee$80
JEFF SIEBEL-04/05/2023 @ 08:28 no violations noted at this time.
NEXT INSPECTION DATE
03/28/2024
CONTACT SIGNATURE
Monte Meyer
Signed on:04/05/2023 @ 08:28 �L
INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:04/05/2023 @ 08:28
Printed on 04/05/2023 @ 08:29
Page 1 of 2
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebei@Waterloo-ia.org
3192301224
Printed on 04/05/2023 @ 08:29
Page 2 of 2