NCC191260_Annual Fee Payment Record_20201112

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 11/10/2020 6:58:57 AM (Workflow Start Event)
Submit by Selkane, Aziza 11/12/2020 10:59:39 AM (Annual Fee Payment Verification for NCC191260-2020)
* Jessica East
• Selkane, Aziza assigned the task to Selkane, Aziza 11/12/2020 10:59 AM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: December 22, 2020 5:00
PM 11/10/2020 6:59 AM

NORTH CAROLINA
Environmental Quvllty
Certificate of NCC191260
Coverage (COC) This is passed fromthe worldlow when the invoice is filed.
No.*
NC Reference COC NCG01-2019-1260
No.*
Permit Status: Active
Project Name* Maple Street/Merritt Street Water Improvemenets
Project Address * Maple, Merritt, Pippen, Porter, Willow Streets, & Rawley Avenue, City of Mount Airy,
NC
Permittee * City of Mount Airy
County Surry
Invoice No. NCC191260-2020
This is passed fromthe worldlow when the invoice is filed.
Annual Fee * $ 100.00
Invoice Date* 11/10/2020
This is passed fromthe worldlow when the invoice is filed.
Invoice Due Date* 12/10/2020
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 Payment 11 /12/2020
Received* Or, if WAN®or NOT FECHV®, this is the date that status is recorded.
Method of Payment*
r electronic
f check
f other
e Payme nt
543950399
Transaction
Number*
Fee Status* PAID

Legally Responsible Mitch Williams, P.E.
Person (Orig.)
Original Permittee E- [e-mail]
mail *
CONFIRM Permittee [e-mail]
E-mail * Opportunity to modify probleme-nail address or perrrittee contact info
Original Site Contact [e-mail]
E-mail *
CONFIRM Site [e-mail]
Contact E-mail * Opportunity to correct probleme-Trail address or site contact info
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 11/12/2020