NCC231506_NOI 141358 Payment Verification_20230517

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 5/16/2023 10:32:44 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 5/16/2023 10:44:49 AM (Review-NOI 141358 Blair Road-Lot 2)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: May 19,2023 5:00 PM
5/16/2023 10:32:54 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 5/16/2023 10:32:54 AM
Submit by Tev.Holloman 5/17/2023 12:05:00 PM (Payment Verification for NCC231506)
•Joshua B Jackson
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:June 27,2023 5:00 PM
5/16/2023 10:45:08 AM
• Tev.Holloman assigned the task to Tev.Holloman 5/17/2023 12:04:16 PM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Blair Road-Lot 2
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
CONFIRMED ARPA Project Number(if applicable)
Lot Numbers (If listed on the eNOI)
2
NC Reference No.* NCG01-2023-1506
Certificate of NCC231506
Coverage(COC)No.*
Invoice Date 5/16/2023
Initial Invoice No. NCC231506-2023
Initial Fee $ 100.00
Invoice Due Date 6/15/2023
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 5/17/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 691342095
Transaction Number*
NOI Tracking No. 141358
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-MECKL-2023-Blair Road-Lot 2

I I