HomeMy WebLinkAbout3815 UNIVERSITY AVE INVOICE DATE DUE DATE INVOICE# TOTAL DUE
j/ilrill�� 1';.� 02/09/2018 03/15/2018 2018-00000159 $80.00
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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-3 815 UNIVERSITY AVE- 1-18-18 FOR BILLING INQUIRY: (319)291-4323
LDescription I Total Price J
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
12631 02/09/2018 03/15/2018 2018-00000159 $80.00
Less Prepayment $0.00
Total Due—* $80.00
City of Waterloo
Commercial Fire Inspection Report
Inspection Number 1202
Prior Inspection 199
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* 3815 University Avenue
Business name Dollar General
Inspection Date* 1/18/2018
Proprietor Tina Peterson
Business Phone 319-226-5736
Email* Tinabobpeterson@yahoo.com
Email 2 tax-beerandwinelicense@dollargcneral.com
Property Owner Tina Peterson
Emergency Contact Tina Peterson
Information
Phone 319-327-0345
Violations
Ref# CODE Violation &Location Corrected
1
Comments: Two prohibited electric heaters were remove in my presence.
No other violations 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 Summit 3/17
Inspection Fee $ 70.00
Occupancy Fee $ 10.00
Re-inspection Fee S
Total Fee* $ 80.00
Received By Tina Peterson
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload (for long
inspections)
Reinspection
Re-inspection# Date Time