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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 AR0049850 <br /> <br /> <br /> 2/2021 <br /> HONEA, LARK RE : LARK'S COTTAGE BAKERY <br /> LARK'S COTTAGE BAKERY 21711 N BRUELLA RD <br /> 21711 N BRUELLA RD ACAMPO, CA 95220 <br /> ACAMPO, CA 95220 <br /> OWNER : HONEA, LARK <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0355630---Date of Invoice: 912312021 III IIIIVIIVIVIIIVI VIIVVIIIVII VI / IIIII 111111111/III <br /> 9/23/2021 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0546349 $ 155.00 <br /> Total for this Invoice $ 155.00 <br /> Payment Due Date 1013012021 <br /> ATTENTION PAST DUE! <br /> YOUR HEALTH PERMIT WE WOULD APPRECIATE YOUR <br /> FOR THE CURRENT YEAR PAYMENT TODAYI <br /> MAY NOT BE ISSUED UNTIL <br /> PAST DUE AMOUNTS ARE <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 fill out the <br /> form at this link to be turned into EHD in order to receive your permit. <br /> https://www.sigov.org/department/envhealth/form <br /> Pq;d I1�3,l <br /> Coll --a 13 5 3 3 15 q� <br /> eo <br /> Would you like Invoices electronically or need to update the email address for this account?Fill out the <br /> form below 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.sigov.org/deliartment/envhealt[Vonline-payment' <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 100/ 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 /> 52i4,rpt End of report <br />