NCC233217_NOI 165391 Payment Verification_20231026

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 10/26/2023 7:38:32 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 10/26/2023 8:08:45 AM (Review-NOI 165391 Liberty Meadows Subdivision Lots 56,
58-62&64-78)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: October 31,2023 5:00
PM 10/26/2023 7:38:40 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 10/26/2023 7:38:40 AM
Submit by Tev.Holloman 10/26/2023 11:06:37 AM (Payment Verification for NCC233217)
0 Shaun Gardner
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: December 7,2023 5:00 PM
10/26/2023 8:09:00 AM
• Tev.Holloman assigned the task to Tev.Holloman 10/26/2023 11:05:57 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Liberty Meadows Subdivision Lots 56,58-62&64-78
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)
56,58-62&64-78
NC Reference No.* NCG01-2023-3217
Certificate of NCC233217
Coverage(COC)No.*
Invoice Date 10/26/2023
Initial Invoice No. NCC233217-2023
Initial Fee $ 120.00
Invoice Due Date 11/25/2023
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 10/26/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 716482451
Transaction Number*
NOI Tracking No. 165391
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-HARNE-2023-Liberty Meadows Subdivision Lots 56,58-62&64-78

I I