NCC223705_NOI 110523 Payment Verification_20221031

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/28/2022 9:11:14 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/28/2022 9:16:27 AM (Review - NOI 110523 Rutkowski Residence)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/28/2022 9:11 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 2, 2022 5:00
PM 10/28/2022 9:11 AM
by Workflow 10/28/2022 9:16:37 AM (Workflow Start Event)
Submit by Holloman, Tevye L 10/31/2022 8:07:08 AM (Payment Verification for NCC223705)
F Sheen Hosseinour
Holloman, Tevye L assigned the task to Holloman, Tevye L 10/31/2022 8:05 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 9, 2022 5:00 PM
10/28/2022 9:16 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Rutkowski Residence
Lot Numbers
(If listed on the eNOI)
3
NC Reference No.*
NCG01-2022-3705
Certificate of
NCC223705
Coverage (COC) No.*
Invoice Date
10/28/2022
Initial Invoice No.
NCC223705-2022
Initial Fee
$ 100.00
Invoice Due Date
11/27/2022
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
10/31/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
659975988
Transaction Number*
NOI Tracking No.
110523
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-ORANG-2022-Rutkowski Residence