NCC193055_Annual Fee Payment Record_20210105

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 12/7/2020 5:18:10 PM (Workflow Start Event)
Submit by Selkane, Aziza 1/5/2021 1:05:01 PM (Annual Fee Payment Verification for NCC193055-2020)
p County of Rockingham
Check is for $200 to cover both NCC193055 and 2020PR011238 for NCG120055
• Selkane, Aziza assigned the task to Selkane, Aziza 1/5/2021 1:03 PM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: January 18, 2021 5:00
PM 12/7/2020 5:18 PM

SfA7$ q,
NORTH CAROLINA
Envlrmmentuf Quuftty
Certificate of NCC193055
Coverage (COC) This is passed fromthe worKlow when the invoice is filed.
No. *
NC Reference COC NCG01-2019-3055
No.*
Permit Status: Active
Project Name * Rockingham County Regional Water Interconnection - Phase 3
Project Address* West NC 704, Madison, NC
Permittee * Rockingham County
County Rockingham
Invoice No.* NCC193055-2020
This is passed from the worldlow when the invoice is filed.
Annual Fee * $ 100.00
Invoice Date* 12/8/2020
This is passed from the worldlow when the invoice is filed.
Invoice Due Date * 1/8/2021
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 1/5/2021
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* 319143
Fee Status* PAID
Legally Responsible Ronald Tate
Person (Orig.)

Original Permittee E- [e-mail]
mail *
CONFIRM Permittee [e-mail]
E-mail * Opportunity to rrodify probleme-nail 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 * 1/5/2021