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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 17AR0050004ji <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID 1A0026320 <br /> Date Printed 10/26/2021 <br /> <br /> <br /> <br /> NOV 2 4 2021 <br /> OWNER : KOHL, KRISTA <br /> SAN <br /> FN', <br /> Health 'n <br /> Date Program Description Amount <br /> Invoice# IN0360587--Date of Invoice: 10126/2021 11111111111111111111 IN IIIIII 1111111111111 <br /> 10/26/2021 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PRO546439 $ 310.00 <br /> Total for this Invoice $ 310.00 <br /> q31 <br /> TOTAL DUE this Billing Period <br /> Important! Cottage Permits require application with every renewal annually. Please download and <br /> form at this link to be turned into EHD in order to receive your permit. <br /> https://www.sigov.org/department/envhealth/forms <br /> PAYMENT' <br /> N NT RECEIVED <br /> CPAYMENT <br /> EIVED �IOv 7 ,, 2071 RECEIVED <br /> all NOV 2 a 2021 <br /> 1INfv7rL <br /> IAL rn ..._,•r . SAUJN LUAUUIN L [i l r <br /> _ . rPAYMENT F. ...,;....._. _ <br /> RECEIVED <br /> ^lnv 9 1, 907.1 <br /> V` 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: 'htti)s://www.s'ciov.orcUdeg)artmentlenvhealttVonline-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.rpt End of report <br />