NCC191578_Annual Fee Payment Record_20210919

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 8/31/2021 7:25:19 AM (Workflow Start Event)
Submit by Morman, Alaina 9/19/2021 12:51:40 PM (2021 Annual Fee Payment Verification for NCC191578-2021)
* Close-out documentation dated 512612021.
• Morman, Alaina assigned the task to Morman, Alaina 9/19/2021 12:51 PM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: October 12, 2021 5:00
PM 8/31/2021 7:25 AM

NORTH CAROLINA
Environmental Quvllty
Certificate of NCC191578
Coverage (COC) This is passed fromthe workflowwhen the invoice isfiled.
No.*
NC Reference COC NCG01-2019-1578
No.*
Permit Status: INACTIVE
Already Rescinded: 9/19/2021
This field appears if the permt has already been terrrinated.
Year COC Issued
2019
This field will be hidden.
2020 Fee Status
Check last year's fee status
PAID
WAIVE FEE? *
r Yes, Payment Not Applicable
f No, Payment Still Applies
Project Name *
State Employees' Credit Union Brier Creek Branch
Project Address* 7800 T.W. Alexander Dr, Raleigh, NC
Permittee *
County
J. D. Beam, Inc.
Wake
Invoice No.* NCC191578-2021
This is passed fromthe workflow when the invoice is filed.
Annual Fee * $ 100.00
Invoice Date* 9/1/2021
This is passed fromthe workflow when the invoice is filed.
Invoice Due Date* 10/1/2021
This is passed from the workflow 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 9/19/2021
Received* Or, if WAN®or NOT FECBV®, this is the date that status is recorded.

e Payme nt
Transaction
Number*
Check Number*
Fee Status* WAIVED
Legally Responsible Tom Antoine
Person (Orig.)
Original Permittee E- [e-mail]
mail*
CONFIRM Permittee [e-mail]
E-mail * Opportunity to modify probleme-rrail address or permttee 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
Original Billing E- (It available)
mail
CONFIRM Billing E- Opportunity to correct probleme-nail address or billing contact info
mail
Billing Telephone
No.
Permittee Email for [e-mail]
30-day Reminder This is the email for the 3aday reminder if needed (passed fromworldlow).
Site Contact Email [e-mail]
for30-day Reminder This is theemailforthe3adayreminderifneeded (passed fromworldlow)
Billing Contact Email This is the email for the 3t}dayreminderifneeded (passed fromworldlow).
for 30-day Reminder
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 9/19/2021