HomeMy WebLinkAbout520 LA PORTE RD INVOICE DATE DUE DATE INVOICE# TOTAL DUE
ra�a ��:•, 03/23/2021 04/26/2021 2021-00000226 $80.00
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Customer#: 9934 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
EL MERCADITO 715 Mulberry St
520 LA PORTE RD WATERLOO, IA 50703
WATERLOO,IA 50702
Amount Enclosed.
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-520 LA PORTE RD-3-22-21 FOR BILLING INQUIRY: (319)291-4323
L Description Total Price J
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
9934 03/23/2021 04/26/2021 2021-00000226 $80.00
Less Prepayment $0.00
Total Due—* $80.00
City of Waterloo
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WATERLOO FIRE RESCUE 4gERLQ0
INSPECTION REPORT ri
EL MERCADITO,520 LA PORTE RD,BLDG 520 LA PORTE RD, WATERLOO IA 50702 4410
DETAILS
Inspection Date:03/22/2021 I Inspection Type:Annual Inspection(1Yr) I Inspection Number:4501 I Shift: N/A Station: N/A I
Unit: N/A I Lead Inspector:JEFF SIEBEL I Other Inspectors: N/A I Fee:$80.00
VIOLATIONS
No Violations Found
GENERAL NOTES
JEFF SIEBEL-03/22/2021 @ 15:03 annual inspection$80
JEFF SIEBEL-03/22/2021 @ 15:03 fire extinguishers due in May.no other violations noted at this time.
NEXT INSPECTION DATE
03/26/2022
CONTACT SIGNATURE
Elida Iedasma �
Signed on:03/22/2021 @ 15:04
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INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:03/22/2021 @ 15:04
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 03/22/2021 @ 15:05
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