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Account ID AR0049259 <br />Facility ID FA0026001 <br />Date Printed 9/8/2022 <br />INVOICE <br />Return This INVOICE with Your PAYMENT <br />1 <br />ATTENTION PAST DUE! <br />YOUR HEALTH PERMIT Delinquent charges over <br />FOR THE CURRENT YEAR 90 days! <br />MAY NOT BE ISSUED UNTIL <br />PAST DUE AMOUNTS ARE <br />PAID IN FULL <br />TOTAL DUE this Billing Periodll 155.00 <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 />TIRAPELLE, NICOLE <br />CRUMBS BY NICOLE <br />249 E FARGO ST <br />STOCKTON, CA 95204 <br />RE: CRUMBS BY NICOLE / <br />249 E FARGO ST <br />STOCKTON, CA 95204 <br />OWNER: TIRAPELLE, NICOLE <br />Date Health <br />Program Description Amount <br />Invoice # IN0366635 --- Date of Invoice: 4/28/2022 <br /> <br />1111111 111111 111 11111 11111 1111 11111 1111 1 11111 11111 111 11 111 1111 111111 11111 III <br />4/28/2022 1 608 CLASS A COTTAGE FOOD-DIRECT SALES <br /> PR0545991 $ 15500 <br />Total for this Invoice <br />Payment Due Date 5/30/2022 <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 />https://www.sigov.org/departmentienvhealthiforms <br />01/1/2_ <br />coi -44 (14”35- <br />155.00 <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: 'https://www.sigov.oraidepartment/envhealth/feesionline-fee-payment <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% <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 />tec,0.5-14*S-Vir <br />End of report 5254.rpt