HomeMy WebLinkAbout201 RATH ST ?,VOICE DATE DUE DATE INVOICE# TOTAL DUE
i1111.1 . 06/20/2018 07/20/2018 2018-00000414 $200.00
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Customer#: 4648 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
PACKERS INN 715 Mulberry St
201 RATH ST WATERLOO, IA 50703
WATERLOO,IA 50703
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-201 RATH ST- 6-14-18 FOR BILLING INQUIRY: (319)291-4323
L Description I Total Price
REINSPECTION 3 $200.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
4648 06/20/2018 07/20/2018 2018-00000414 $200.00
Less Prepayment $0.00
Total Due $200.00
City of Waterloo
REINSPECTION - Commercia-Fire Inspection Form
Inspection Number 194
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* 201 Rath Street
Business Name Packers Inn
Inspection Date* 6/14/2018
Proprietor Donna Engleman
Business Phone 319-234-8456
Email* cindy.young@waterloo-ia.org
Email 2
Property Owner Donna Engleman
Emergency Contact Donna Engleman
Information
Phone 319-230-2880
Violations
Ref# Code Violation &Location Corrected
1 4.A. Repair/replace light above cash register. Properly
contain exposed wiring with a listed enclosure
Comments:
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 f$200-Third and subsequent Re-inspections
Reports
Reports
Comment
Inspection Fee $
Occupancy Fee $
Re-inspection Fee $ 200.00
Total Fee* $ 200,00
Received By Bartender
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload(for long
inspections)
Reinspection
Re-inspection Date Time
6 7/11/2018