HomeMy WebLinkAbout313 W 5TH ST Ov W.4 T, INVOICE DATE DUE DATE INVOICE# TOTAL DUE
11/15/2023 12/20/2023 2024-00000195 $80.00
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Customer#: 21928 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
CLUB AMBASSADOR 715 Mulberry St
313 W 5TH ST WATERLOO, IA 50703
WATERLOO, IA 50701
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 313 W 5TH ST- 11-2-23 FOR BILLING INQUIRY: (319)291-4323
[Description Total Price J
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
21928 11/15/2023 12/20/2023 2024-00000195 $80.00
Less Prepayment $0.00
Total Due-> $80.00
City of Waterloo
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
CLUB AMBASSADOR,313 W 5TH ST BLDG 313 W 5TH ST,WATERLOO IA 50702 7-ack 41;10°
DETAILS
Inspection Date: 11/02/2023 Inspection Type:Annual Inspection(1Yr) j Inspection Number:9119 Shift: N/A Station: N/A
Unit: N/A Lead Inspector:JEFF SIEBEL i Other Inspectors: N/A j Fee:$80.00
VIOLATIONS
No Violations Found
GENERAL NOTES
JEFF SIEBEL-11/06/2023 @ 08:15 exit light above alley door repaired as a result of inspection.
JEFF SIEBEL-11/06/2023 @ 08:15 annual inspection$80
NEXT INSPECTION DATE
11/02/2024
CONTACT SIGNATURE
Nedzad Rekic
Signed on:11/06/2023 @ 08:16 L
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INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on: 11/06/2023 @ 08:16
Printed on 11/06/2023 @ 08:24
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QUESTIONS ADOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 11/06/2023 @ 08:24
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