NCC190855_Annual Fee Payment Record_20201125

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 11/3/2020 7:07:57 AM (Workflow Start Event)
Submit by Selkane, Aziza 11/25/2020 9:07:05 AM (Annual Fee Payment Verification for NCC190855-2020)
* Life Springs Church, Inc
• Selkane, Aziza assigned the task to Selkane, Aziza 11/25/2020 9:06 AM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: December 15, 2020 5:00
PM 11/3/2020 7:08 AM

SfA7$ q,
NORTH CAROLINA
Envlrmmentuf Quuftty
Certificate of
NCC190855
Coverage (COC)
This is passed fromthe worKlow when the invoice is filed.
No. *
NC Reference COC
NCG01-2019-0855
No.*
Permit Status:
Active
Project Name *
Life Springs Church
Project Address*
3215 Keller Andrews Road, Sanford, NC
Permittee *
Life Springs Church
County
Lee
Invoice No.*
NCC190855-2020
This is passed from the worldlow when the invoice is filed.
Annual Fee *
$ 100.00
Invoice Date*
11/3/2020
This is passed from the worldlow when the invoice is filed.
Invoice Due Date *
12/3/2020
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 11 /25/2020
Received * Or, if WAN® or NOT FECBV®, this is the date that status is recorded.
Method of Payment* r electronic
IT check
f other
Check Number* 13140
Fee Status* PAID
Legally Responsible Shane Wilson
Person (Orig.)

Original Permittee E- [e-mail]
mail *
CONFIRM Permittee [e-mail]
E-mail * Opportunity to modify probleme-rrail address or perrrittee contact info
Original Site Contact [e-mail]
E-mail *
CONFIRM Site [e-mail]
Contact E-mail * Opportunity to correct problem e-mail address or site contact info
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 11/25/2020