NCC233144_NOI 164616 Payment Verification_20231019

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 10/19/2023 8:16:42 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 10/19/2023 8:20:51 AM (Review-NOI 164616 The Preserve at Lake Upchurch,
Phase 2,Section 3-Lots 53-57, 132, 134& 135)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: October 24,2023 5:00
PM 10/19/2023 8:16:50 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 10/19/2023 8:16:50 AM
Submit by Tev.Holloman 10/19/2023 12:06:06 PM (Payment Verification for NCC233144)
0 Leslie Groves
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: November 30,2023 5:00
PM 10/19/2023 8:21:05 AM
• Tev.Holloman assigned the task to Tev.Holloman 10/19/2023 12:05:27 PM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name The Preserve at Lake Upchurch, Phase 2,Section 3-Lots 53-57, 132, 134&135
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
CONFIRMED ARPA Project Number(if applicable)
Lot Numbers (If listed on the eNOI)
Lots 53-57, 132, 134&135
NC Reference No.* NCG01-2023-3144
Certificate of NCC233144
Coverage(COC)No.*
Invoice Date 10/19/2023
Initial Invoice No. NCC233144-2023
Initial Fee $ 120.00
Invoice Due Date 11/18/2023
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 10/19/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 715442028
Transaction Number*
NOI Tracking No. 164616
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CUMBE-2023-The Preserve at Lake Upchurch, Phase 2,Section 3-Lots 53-
57, 132, 134&135

i i