Laserfiche WebLink
Account ID AR0052458 <br />Facility ID FA0027280 <br />Date Printed 6/6/2023 <br />INVOICE <br />Return This INVOICE with Your PAYMENT <br />I <br />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 />HOMON, KAITLYN <br />BLUE ROSE BAKERY & TEA <br />1007 MARINERS COVE <br />LATHROP, CA 95330 <br />RE: BLUE ROSE BAKERY & TEA <br />1007 MARINERS COVE <br />LATHROP, CA 95330 <br />OWNER: HOMON, KAITLYN <br />Date Health <br />Program Description Amount <br />Invoice # IN0381416 --- Date of Invoice : 5/30/2023 <br /> <br />1 11 11111 111111 111 11111 1111111010111 1111111 11111111 II 11011111 0 110 1110 1111 11 11 <br />5/30/2023 1608 CLASS A COTTAGE FOOD-DIRECT SALES <br /> PRO547863 <br /> <br />186.00 <br />Total for this Invoice 186.00 <br /> <br />Payment Due Date 6/30/2023 <br /> <br />TOTAL DUE this Billing Period 186.00 <br /> <br />ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOIC YOU <br />NEED TO COMPLETE AND RETURN THE RENEWAL FORM AND INCLUDE A LABEL OF ONE OF <br />CFO PRODUCTS. CFO RENEWAL FORM HERE: <br />https://www.sjgov.org/docs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-permittin <br />g-renewal-form.pdf?sfvrsn=d950fb44 5 <https://gcc02.safelinks. protection .outlook.com/? <br />url=https%3A%2F%2Fwww. .sigov.org%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-resta <br />urants%2Fcfo-registration-permitting-renewal-form.pdf%3Fsfvrsn%3Dd950fb44 5&data=05%7C01%7Cjsalwolke%40sig <br />ov.org%7C0d058e9dfbee4d8f10c308dab2233bdc%7C3cff5075176a400d860a54960a7c7e51%7C0%7C0%7C63801816164 <br />0113088%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAILCJOIjoiV2IuMz1iLCJBTil6IklhaWwiLCJXVCI <br />6Mn0%3D%7C3000%7C%7C%7C&sdata=6tRcKMC6hxT5tygqQ4bBY121mMj7b53zNcmtPtD%2FYTA%3D&reserved= <br />0> <br />You can return by mail to our department at the address on the top of your invoice or email completed forms and <br />N111111. e <br />sk <br />Please make Checks PAYABLE to: 'END' <br />or <br />Pay online at: 'httos://www.sjgov.orq/department/envhealth/fees/online-fee-oayment' <br />Penalties will be added to all Permit Fees <br /> 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% <br /> <br />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 />ci( fo 672/2 3 <br />5254.rpt End of report