NCC230176_NOI 123302 Payment Verification_20230120

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/19/2023 11:50:54 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 1/20/2023 6:23:34 AM (Review - NOI 123302 South Fork Village - Phase 1)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 1/19/2023 11:51 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 24, 2023 5:00
PM 1/19/2023 11:51 AM
by Workflow 1/20/2023 6:24:10 AM (Workflow Start Event)
Submit by Holloman, Tevye L 1/20/2023 9:28:54 AM (Payment Verification for NCC230176)
F Clay Mize
Holloman, Tevye L assigned the task to Holloman, Tevye L 1/20/2023 9:27 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 3, 2023 5:00 PM
1/20/2023 6:24 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
South Fork Village - Phase 1
Lot Numbers
(If listed on the eNOI)
1-124
NC Reference No.*
NCG01-2023-0176
Certificate of
NCC230176
Coverage (COC) No.*
Invoice Date
1/20/2023
Initial Invoice No.
NCC230176-2023
Initial Fee
$ 100.00
Invoice Due Date
2/19/2023
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
1/20/2023
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
672571445
Transaction Number*
NOI Tracking No.
123302
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-FORSY-2023-South Fork Village - Phase 1