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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />Page 1 <br />Account ID AR0051346 <br />INVOICE <br />Return This INVOICE with Your PAYMENT Fa°"" °LMOMMOMMMFA0026886MA <br />Date Printed 12/13/2021 <br /> <br /> <br /> <br /> <br />OWNER: MADRIGAL, CYNTHIA L <br />Date Health <br />Program Description Amount <br />Invoice # IN0362538 --- Date of Invoice: 12/1312021 <br />12/13/2021 1608 CLASS A COTTAGE FOOD -DIRECT SALES <br />I )IIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII I )IIII IIII IIIIII VIII IIII IIII <br />PRO547322 $ 5.00 <br />Total for this Invoice $ 155. 0 <br />TOTAL DUE this Billing Period <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 />htti)s://www.s6gov.org/department/envhealth/form <br />PAYMENII <br />RECEIVED) <br />DEC 13 2021 <br />S1,N JOAW11N COUNTY <br />ENVIHONMENiPL <br />HLPl1N UEPPRiMENi <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:'hftps://www.sipov.orddepartment/envhealtiVonline-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 />5254stit End of report <br />