NCC190020_Annual Fee Payment Record_20201028

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 10/20/2020 9:48:06 AM (Workflow Start Event)
Submit by Selkane, Aziza 10/28/2020 3:56:51 PM (Annual Fee Payment Verification for NCC190020-2020)
* Jernigan Oil & Propane
• Selkane, Aziza assigned the task to Selkane, Aziza 10/28/2020 3:56 PM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: December 1, 2020 5:00
PM 10/20/2020 9:48 AM

SfA7$ q,
NORTH CAROLINA
Envlrmmentuf Quuftty
Certificate of
NCC190020
Coverage (COC)
This is passed fromthe worKlow when the invoice is filed.
No. *
NC Reference COC
NCG01-2019-0020
No.*
Permit Status:
Active
Project Name *
Duck Thru Windsor - US HWY 13/17 Bypass
Project Address*
211 US 13 Bypass, Windsor, NC
Permittee *
Harrell Acquisitions, LLC
County
Bertie
Invoice No.*
NCC190020-2020
This is passed from the worldlow when the invoice is filed.
Annual Fee *
$ 100.00
Invoice Date*
10/20/2020
This is passed from the worldlow when the invoice is filed.
Invoice Due Date *
11/20/2020
This is passed from the woMlow when the invoice is filed.
An automated email reminder is sent to the permittee when the invoice is due. Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Important: If you change the choice below to Payment NOT RECEIVED, the fee status becomes PAST DUE, and the
permittee will receive a Notice of Deficiency.
Annual Fee Payment r Fee Payment Received or Not Applicable.
Received* r Fee Payment NOT RECEIVED.
Date Payme nt 10/28/2020
Received * Or, if WAN® or NDT FCBV®, this is the date that status is recorded.
Method of Payment* r electronic
IT check
f other
Check Number* 106730
Fee Status* PAID
Legally Responsible J. Michael Harrell
Person (Orig.)

Original Permittee E- [e-mail]
mail *
CONFIRM Permittee [e-mail]
E-mail * Opportunity to rrodify problem e-mail address or perrrittee contact info
Original Site Contact [e-mail]
E-mail *
CONFIRM Site [e-mail]
Contact E-mail * Opportunity to correct problem e-rrail address or site contact info
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 10/28/2020