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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0050452 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT FaciiiTyID FA0026501 <br /> Date Printed 3/27/2023 <br /> EDSELL, JULIE RE : ELLIOTT ROAD BARN <br /> ELLIOTT ROAD BARN 23216 N ELLIOTT RD <br /> 23216 N ELLIOTT RD ACAMPO, CA 95220 <br /> ACAMPO, CA 95220 <br /> OWNER : EDSELL, JULIE M <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0377820---Date of Invoice: 2/16/2023 I III IIIIII III IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIIIII IIIII IIII IIII <br /> 2/16/2023 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0546753 $ 186.00 <br /> Total for this Invoice $ 186.00 <br /> Payment Due Date 3130/2023 <br /> SECOND NOTICE <br /> TOTAL DUE this Billing Period 186.00 <br /> ATTENTION! Y F ILL NOT B B L AYIN . YO <br /> NEED TO COMPLETE AND RETURN THE RENEWAL FORM AND INCLUDE A LABEL OF ONE O OUR <br /> CFO PRODUCTS. CFO RENEWAL FORM HERE: <br /> httos://www sieov.orp/does/default-source/environmental-health-dOCL[ments/food-and-restaurants/cfo-registration-permittin <br /> e=renewal-form.pdf?sfvrsn=d950tb44 5 <https:Hacc02.safelinks.protection.outlook.com/? <br /> url=https%3 A%2F%2Fwww.sjgov.ore%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-resta <br /> urants%2Fcfo-registration-permitting-renewal-form pdf%3Fsfvrsn%3Dd950tb44 5&data=05%7C0I%7Cjsalwolke%40sjg <br /> ov.org%7COd058e9dfbee4d8fl Oc3O8dab2233bdc%7C3cff5075176a400d860a54960a7c7e5l%7C0%7CO%7C63801816164 <br /> O 113088%7CUnknown%7CTW FpbGZsb3 d8e�J WljoiMC4wLjAwMDAiLCJOIjoiV2luMzliLCJBTil6lk 1 haWwiLCJXVCI <br /> 6Mn0%3 D%7C3 000%7C%7C%7C&sdata=6tRc KMC6 hxT5ty 2gO4bBY 121mMj7 b53zNcmtPtD%2FYTA%3 D&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 /> Pf\,d # IS6 3/z3/13 <br /> mn� I S% 270 30 <br /> y � <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'httos://www.sjgov.org/departmenttenvhealthlfees/online-fee-Daymenf <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.rpl w5,kpT '3 End of report <br />