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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E HAT_ELTON AVENUE STOCKTON, CA 95205 Phone: (209)468-3420 OWNER: HARRIS, ANNETTE Page 1 AR0047288 FA0025146 2/10/2022 Date Health Program Description Amount Invoice # IN0363665 --- Date of Invoice : 112812022 1/28/2022 1608 CLASS A COTTAGE FOOD -DIRECT SALES I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII PR0544246 $ 155.00 Total forthis Invoice I $ 155.00 Payment Due Date TOTAL DUE this Billing Period $ 155.00 Important! Cottage Permits require application with every renewal annually. Please download and fill o the form at this link to be turned into EHD in order to receive your permit. htt os: //www. s igov. o re/d a na rt m e nt/e nvh e a It h /form s PAYMENT RECEIVED 3 c6 �5 S 3 FEB 10 2022 J SANN COUNTY ENVIRONMENTAL \ HEALTH DEPARTMENT eoWould you like Invoices electronically or need to update the email address for this account? Fill out the form below with the information with up to 2 email addresses: Email 1 Email 2 Please make Checks PAYABLE to: 'EHD' or Pay online at: 'httos:///www.siaov.ora/department/envhealth/fees/online-feeoaymentora/departmentlenvhealth/fees/online-fee-payment' Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES 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% 30 Days after the Due Date 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter 5254.rpt V -6151A11/9 / End ofrepon AccountlD INVOICE Return This INVOICE with Your PAYMENT Facility ID Date Printed OWNER: HARRIS, ANNETTE Page 1 AR0047288 FA0025146 2/10/2022 Date Health Program Description Amount Invoice # IN0363665 --- Date of Invoice : 112812022 1/28/2022 1608 CLASS A COTTAGE FOOD -DIRECT SALES I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII PR0544246 $ 155.00 Total forthis Invoice I $ 155.00 Payment Due Date TOTAL DUE this Billing Period $ 155.00 Important! Cottage Permits require application with every renewal annually. Please download and fill o the form at this link to be turned into EHD in order to receive your permit. htt os: //www. s igov. o re/d a na rt m e nt/e nvh e a It h /form s PAYMENT RECEIVED 3 c6 �5 S 3 FEB 10 2022 J SANN COUNTY ENVIRONMENTAL \ HEALTH DEPARTMENT eoWould you like Invoices electronically or need to update the email address for this account? Fill out the form below with the information with up to 2 email addresses: Email 1 Email 2 Please make Checks PAYABLE to: 'EHD' or Pay online at: 'httos:///www.siaov.ora/department/envhealth/fees/online-feeoaymentora/departmentlenvhealth/fees/online-fee-payment' Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES 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% 30 Days after the Due Date 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter 5254.rpt V -6151A11/9 / End ofrepon