NCC223580_NOI 109367 Payment Verification_20221026

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/16/2022 1:10:12 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/17/2022 6:36:20 AM (Review - NOI 109367 Corina Petruse)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/16/2022 1:10 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 20, 2022 5:00
PM 10/16/2022 1:10 AM
by Workflow 10/17/2022 6:36:31 AM (Workflow Start Event)
Submit by Holloman, Tevye L 10/26/2022 10:41:05 AM (Payment Verification for NCC223580)
F Daniel & Corina Petruse
Holloman, Tevye L assigned the task to Holloman, Tevye L 10/26/2022 10:40 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 28, 2022 5:00
PM 10/17/2022 6:36 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Corina Petruse
Lot Numbers
(If listed on the eNOI)
323
NC Reference No.*
NCG01-2022-3580
Certificate of
NCC223580
Coverage (COC) No.*
Invoice Date
10/17/2022
Initial Invoice No.
NCC223580-2022
Initial Fee
$ 100.00
Invoice Due Date
11/16/2022
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
10/26/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
148
NOI Tracking No.
109367
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-CALDW-2021-Corina Petruse