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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0039999 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility 10 FAooz,s5, <br /> Date Printed 10/5/2021 <br /> <br /> <br /> <br /> <br /> OWNER : DRAKE, PATTI-LYNNE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0354249---Date of Invoice: 712712021 IIIIIIIIVII VIII VIII VIIVIVIIVIVIIVIIIIIIIII IIIIIIIII IIII <br /> 7/27/2021 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0538015 $ 155.00 <br /> Total for this Invoice $ 155.00 <br /> Payment Due Date 813012021 <br /> ATTENTION PAST DUE! <br /> YOUR HEALTH PERMIT WE WOULD APPRECIATE YOUR <br /> PAYMENT TODAY! <br /> FOR THE CURRENT YEAR <br /> MAY NOT BE ISSUED UNTIL <br /> PAST DUE AMOUNTS ARE 1325- 19173 <br /> PAID IN FULL <br /> TOTAL DUE this Billing Period $ 155.00 <br /> Important! Cottage Permits require application with every renewal annually. Please download and fi e <br /> form at this link to be turned into EHD in order to receive your permit. <br /> https://www.s iaov.o rg/u ploa d edfi les/sic/departments/ehd/forms/cfo%20reg-berm itti na%20renewa I%20form.pdf <br /> \/`J Would you like Invoices electronically or need to update the email address for this account?Fill out the <br /> form below or Email us at EH-Invoices@sjgov.org with the information with up to 2 email addresses: <br /> Email 1 <br /> Email 2 <br /> Please make Checks PAYABLE to: 'EHD'or <br /> Pay online at: 'https://www.sioov.oro/departmentienvhealtIvonline-Dayment' <br /> Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpl ®1l 06- End of report <br />