HomeMy WebLinkAbout3260 UNIVERSITY AVE #2879 INVOICE DATE DUE DATE
INVOICE# TOTAL DUE
0111411\k_iZralli0rAi03/01/2018 04/05/2018 2018-00000223 $80.00
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Customer#: 14657 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
715 Mulberry St
CASEY'S GENERAL STORE-UNIVERSITY WATERLOO, IA 50703
P.O.BOX 3001
ANKENY,IA 50021 Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION -3260 UNIVERSITYI
AVE #2879-3- FOR BILLING INQUIRY: (319)291-4323 I
28-18
I Total Price
[Description
$70.00
INSPECTION 2,000 $10.00
OCCUPANCY FEE
DUE DATE INVOICE# CHARGES
14657 03/01/2018
CUSTOMER# I
BILLING DATE 04/05/2018 I 2018-00000223 $80.00 Less Prepayment $0.00
Total Due--- $80.00
City of Waterloo
,Comrtkercial Fire Inspection Report
Inspection Number 1330
Prior Inspection 291
Number Fill this field if it is available, it will auto-fill business name and address.
Inspector* Jeff Siebel
Waterloo Fire Rescue
715 Mulberry Street Waterloo, IA 50703
Phone(319)-230-1224 Fax. (319)-291-4262
Email:Jeff.Siebel@waterloo-ia.org
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Address* 3260 University Avenue
Business name Caseys General Store#2879
Inspection Date* 3/28/2018
Proprietor Jessica Fisher 515-446-6404
Business Phone 319-234-2244
Email* jessica.fisher@caseys.com
Email 2
Property Owner Caseys General Store Corporation
Emergency Contact Kim Frost
Information
Phone 319-230-9370
Violations
CODE Violation &Location
Corrected
Ref#
609.3.3.1 Provide current semi-annual kitchen hood exhaust system
cleaning/inspection report with all deficiencies corrected.
2 904.11.6. Provide current semi-annual kitchen hood fire suppression system
2 inspection/testing with all deficiencies corrected by a contractor
certified to work in the State of Iowa
3 Reduce storage to a minimum of 24"below ceiling in freezer, back
storage room and through out store.
4 Repair egress light by pizza counter
CODE Violation &Location Corrected
Ref#
5 Remove obstructions. Maintain a minimum of 36"clearance to
electrical panel at all times.
6 Provide documentation of dryer vent cleaning to outside the
building.
Repair egress light above gift cards
8 Repair outside outlet weather proof covers.
Comments: ESD was tested ok .
If violations noted during the inspection are not corrected by the given re-inspection date, additional fees
are as follows:
S100.00 -First Re-inspection I$150.00 -Second Re-inspection I$200 -Third and subsequent Re.inspections
Reports
Reports
Comment
Inspection Fee S 70.00
Occupancy Fee S 10.00
Re-inspection Fee S
Total Fee* S 80.00
Received By Dianna Brown
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload (for long
inspections)
Reinspection
Re-inspection# Date Time
1 3/21/2018