NCC223405_NOI 106821 Payment Verification_20221004

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/28/2022 1:23:45 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 9/29/2022 7:15:10 AM (Review - NOI 106821 Holly Grove)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/28/2022 1:24 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 3, 2022 5:00 PM
9/28/2022 1:24 PM
by Workflow 9/29/2022 7:15:18 AM (Workflow Start Event)
Submit by Holloman, Tevye L 10/4/2022 1:18:20 PM (Payment Verification for NCC223405)
F Holly Grove Development Partners LLC
Holloman, Tevye L assigned the task to Holloman, Tevye L 10/4/2022 1:16 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 10, 2022 5:00
PM 9/29/2022 7:15 AM

Payment •
NORTH CAROLINA
Environmental Quallty
Project Name
Holly Grove
Lot Numbers
(If listed on the eNOI)
1-127
NC Reference No.*
NCG01-2022-3405
Certificate of
NCC223405
Coverage (COC) No.*
Invoice Date
9/29/2022
Initial Invoice No.
NCC223405-2022
Initial Fee
$ 100.00
Invoice Due Date
10/29/2022
Important: If you change the choice below to Payment NOT RECEIVED, the application will be rejected, and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received*
Payment Received.
Payment NOT RECEIVED.
Payment Status
PAID
Date Payment
10/4/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
1708
NOI Tracking No.
106821
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-CABAR-2022-Holly Grove