HomeMy WebLinkAbout201 RATH ST INVOICE DATE DUE DATE INVOICE# TOTAL DUE
�■�r .. 05/16/2018 06/20/2018 2018-00000324 $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-5-3-18 FOR BILLING INQUIRY: (319)291-4323
L Description I Total Price
REINSPECTION 3 $200.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
4648 05/16/2018 06/20/2018 2018-00000324 $200.00
Less Prepayment $0.00
Total Due -* $200.00
City of Waterloo
REIN PEGTION - Commercial 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* 5/3/2018
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 2. Immediately and PERMANTENLY REMOVE surface
mount slide bolt lock and hardware on parking lot door.
Was re-installed on 4/11 and today,5/2 @ 2:15 pm.
2 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 I$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
5 5/16/2018