HomeMy WebLinkAbout1650 IDAHO ST W i r INVOICE DATE DUE DATE INVOICE# TOTAL DUE
� t* - 11/01/2023 12/10/2023 2024-00000139 $80.00
y
0
Customer#: 12631 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
DOLLAR GENERAL 715 Mulberry St
100 MISSION RIDGE WATERLOO, IA 50703
GOODLETTSVILLE, TN 37072
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 1650 IDAHO ST- 9-29-23 FOR BILLING INQUIRY: (319)291-4323
LDescription Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
12631 11/01/2023 12/10/2023 2024-00000139 $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.
()-0
WATERLOO FIRE RESCUE
INSPECTION REPORT t r
DOLLAR GENERAL,1650 IDAHO STS,BLDG DOLLAR GENERAL,WATERLOO IA S0613
DETAILS
Inspection Date:09/29/2023 Inspection Type:Annual Inspection(1Yr) I Inspection Number:9120 j Shift: N/A f Station: N/A
Unit: N/A Lead Inspector:JEFF SIEBEL 1 Other Inspectors: N/A Fee:$80.00
VIOLATIONS
No Violations Found
GENERAL NOTES
JEFF SIEBEL-10/02/2023 @ 14:33 Back aisle running east and west was being cleared during inspection.
JEFF SIEBEL-10/02/2023 @ 14:17 annual inspection fee$80
NEXT INSPECTION DATE
09/29/2024
CONTACT SIGNATURE
Adam Blackburn-District Manager J al 1->
Signed on:10/02/2023 @ 14:35
INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:10/02/2023 @ 14:35
Printed on 10/02/2023 @ 14:37
Page 1 of 2
QUESTIONS ASOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 10/02/2023 @ 14:37
Page 2 of 2