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SAN JOAQUIN COUNTY <br /> ENViRONMIENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0051159 <br /> <br /> <br /> e Printed 10/4/2022 <br /> ORK, NANCY RE : 143 MY CREATIONS <br /> 143 MY CREATIONS 709 GOTHAM DR <br /> 709 GOTHAM DR STOCKTON, CA 95210 <br /> STOCKTON, CA 95210 <br /> OWNER : ORK, NANCY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IND369182---Date of Invoice: 8/3012022 (IIIIII IIIIII III IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIIIII IIIII IIII IIII <br /> 8/30/2022 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0547254 $ 186.00 <br /> Total for this Invoice $ 186.00 <br /> Payment Due Date 9/3012022 <br /> SECOND NOTICE <br /> TOTAL DUE this Billing Period $ 186.00 <br /> Cottage Permits require application with every renewal annually. Please download and fill out the form at this link to be to ned into EH <br /> htti3s://www.sigov,org/department/envhealth/forrn <br /> Con 5� (7 v <br /> 101, <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'httos:I/www.siaov.oraldeoartment/envhealtWfeeslonline-fee-oavment' <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 />