HomeMy WebLinkAbout1214 FRANKLIN ST INVOICE DATE DUE DATE INVOICE# TOTAL DUE
/li�,alP■,. r ri•; 06/20/2018 07/20/2018 2018-00000408 $80.00
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Customer#: 7075 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
KWIK STAR#722 715 Mulberry St
1626 OAK ST WATERLOO, IA 50703
LA CROSS, WI 54602
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 1214 FRANKLIN ST-6-18-18 FOR BILLING INQUIRY: (319)291-4323
Description s. Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
7075 06/20/2018 07/20/2018 2018-00000408 $80.00
Less Prepayment $0.00
Total Due— $80.00
City of Waterloo
Commercial Fire Inspection Report
Inspection Number 1576
Prior inspection 460
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
File Upload
Address* 1214 Franklin Street
Business name Kwik Star
inspection Date* 6/18/2018
Proprietor Amanda Thomas
Business Phone 319-404-9494
Email* licensiingdept@kwiktrip.com
Email 2 dhafner@kwiktrip.com
Property Owner Kwik Triip Corp
Emergency Contact Amanda Thomas
information
Phone 319-404-9494
Violations
Ref# CODE Violation &Location Corrected
1
Comments: No violations noted at this time.
If violations noted during the inspection are not corrected by the given re-inspection date,additional fees
are as follows:
$100.00-First Re-inspection I$150.00-Second Re-inspection I$200-Third and subsequent Re-inspections
Reports
Reports Fire Extinguisher Service
Comment Kwik Trip Inc. 8/17
Inspection Fee $ 70.00
Occupancy Fee $ 10.00
Re-inspection Fee $
Total Fee* $ 80.00
Received By Mgr
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload(for long
inspections)
Reinspection
Re-inspection# Date Time