NCC223915_NOI 113860 Payment Verification_20221122

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/21/2022 9:49:56 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/21/2022 9:57:14 AM (Review - NOI 113860 South Boulevard MOB)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/21/2022 9:50 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 24, 2022 5:00
PM 11/21/2022 9:50 AM
by Workflow 11/21/2022 9:57:25 AM (Workflow Start Event)
Submit by Holloman, Tevye L 11/22/2022 9:18:56 AM (Payment Verification for NCC223915)
P Kevin S. Caldwell
Holloman, Tevye L assigned the task to Holloman, Tevye L 11/22/2022 9:15 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 2, 2023 5:00 PM
11/21/2022 9:57 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
South Boulevard MOB
Lot Numbers
(If listed on the eNOI)
6859 South Boulevard, Charlotte, NC
NC Reference No.*
NCG01-2022-3915
Certificate of
NCC223915
Coverage (COC) No.*
Invoice Date
11/21/2022
Initial Invoice No.
NCC223915-2022
Initial Fee
$ 100.00
Invoice Due Date
12/21/2022
Important: If you change the choice below to Payment NOT RECEIVED, the application will be rejected, and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received*
• Payment Received.
Payment NOT RECEIVED.
Payment Status
PAID
Date Payment
11/22/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
663538503
Transaction Number*
NOI Tracking No.
113860
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-MECKL-2022-South Boulevard MOB