NCC241896_NOI 202979 Payment Verification_20240621

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/19/2024 2:49:57 PM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 6/20/2024 6:37:40 AM (Review-NOI 202979 Carolina Meadows Skilled Nursing)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:June 24,2024 5:00 PM
6/19/2024 2:50:05 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 6/19/2024 2:50:05 PM
Submit by Tev.Holloman 6/21/2024 11:08:09 AM (Payment Verification for NCC241896)
•NV5 INC
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:August 1,2024 5:00 PM
6/20/2024 6:37:55 AM
• Tev.Holloman assigned the task to Tev.Holloman 6/21/2024 11:07:44 AM

Payment Verification
NORTH CAROLINA
Environmental Quality
Project Name Carolina Meadows Skilled Nursing
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 eNOl)
20033
64734
NC Reference No.*
NCG01-2024-1896
Certificate of Coverage(COC)No.* Permit Version
NCC241896 1.00
Invoice Date 6/20/2024
Initial Invoice No. NCC241896-2024
Initial Fee $ 120.00
Invoice Due Date 7/20/2024
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 6/21/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 753924713
Transaction Number*
NOI Tracking No. 202979
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes

Project Tracking ID NCC-CHATH-2024-Carolina Meadows Skilled Nursing