NCC223869_NOI 113335 Payment Verification_20221207

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/16/2022 6:27:11 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/17/2022 7:28:12 AM (Review - NOI 113335 Serenity Phases 1 D, 1 E, 2C, 2D,
2F, 2G, 6A, 6B, 6C, 6D, 6E, 6F & 6G)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/16/2022 6:27 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 21, 2022 5:00
PM 11/16/2022 6:27 PM
by Workflow 11/17/2022 7:28:19 AM (Workflow Start Event)
Submit by Holloman, Tevye L 12/7/2022 11:05:13 AM (Payment Verification for NCC223869)
* Greenfield Serenity LLC
• Holloman, Tevye L assigned the task to Holloman, Tevye L 12/7/2022 11:04 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 29, 2022 5:00
PM 11/17/2022 7:28 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Serenity Phases 1 D, 1 E, 2C, 2D, 2F, 2G, 6A, 6B, 6C, 6D, 6E, 6F & 6G
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2022-3869
Certificate of NCC223869
Coverage (COC) No.*
Invoice Date 11/17/2022
Initial Invoice No. NCC223869-2022
Initial Fee $ 100.00
Invoice Due Date 12/17/2022
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 12/7/2022
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 665869938
Transaction Number*
NOI Tracking No. 113335
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-HARNE-2022-Serenity Phases 1 D, 1 E, 2C, 2D, 2F, 2G, 6A, 6B, 6C, 6D, 6E,
6F & 6G