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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTOIN, CA 95205 <br /> Phof!i: (20) 468.3420 <br /> Account ID AR0049607 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0026159 <br /> Date Printed 7/27/2021 <br /> <br /> <br /> <br /> <br /> OWNER : LEYVA, DEILANI <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0354261 —Date of Invoice: 7127/2021 IIIIIIIIIIIVIIIIIIVIIVIIIVIIIVIIIVIIIVIVIIIIIIIIIIIIIIIIIIIII <br /> 7/27/2021 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PR0546214 $ 310.00 <br /> Total for this Invoice $ 310.00 <br /> 1 <br /> TOTAL DUE this Billing Period 310.00 <br /> Cottage Permits require application with every renewal annually. Please download and fill out the form at this link to be to ned into EHD. <br /> htts: www.s' ov.or u loadedfiles sac de artments ehd forms cfo%20re - ermitbn o20renewap/620 rm. df <br /> PAYMENT <br /> RECENE® <br /> AUG 2� 221 <br /> S 0 HO14MFN E14 <br /> �3 <br /> I �� o <br /> V" 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 /> V Email 1 f' 1 G fti \ co Lc <br /> Email 2 <br /> Please make Checks PAYABLE to: 'EHD'or <br /> Pay online at: 'https://www.siciov.orcjdeoartmentlenvhealth/online-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 r^ 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt !n End of report <br />