NCC223663_NOI 110107 Payment Verification_20221108

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/25/2022 9:02:34 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/25/2022 9:14:48 AM (Review - NOI 110107 Highland Farms)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/25/2022 9:03 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 28, 2022 5:00
PM 10/25/2022 9:03 AM
by Workflow 10/25/2022 9:14:56 AM (Workflow Start Event)
Submit by Holloman, Tevye L 11/8/2022 8:38:18 AM (Payment Verification for NCC223663)
F Steven Cawn
Holloman, Tevye L assigned the task to Holloman, Tevye L 11/8/2022 8:37 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 6, 2022 5:00 PM
10/25/2022 9:15 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Highland Farms
Lot Numbers
(If listed on the eNOI)
Lot 3
NC Reference No.*
NCG01-2022-3663
Certificate of
NCC223663
Coverage (COC) No.*
Invoice Date
10/25/2022
Initial Invoice No.
NCC223663-2022
Initial Fee
$ 100.00
Invoice Due Date
11/24/2022
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
11/8/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
661483958
Transaction Number*
NOI Tracking No.
110107
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-CHATH-2022-Highland Farms