NCC242926_NOI 218676 Payment Verification_20240926

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 9/19/2024 6:59:19 PM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 9/20/2024 7:06:16 AM (Review-NOI 218676 Shamrock Forest)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: September 24,2024 5:00
PM 9/19/2024 6:59:34 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 9/19/2024 6:59:34 PM
Submit by Tev.Holloman 9/26/2024 1:57:10 PM (Payment Verification for NCC242926)
•David Traffie
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: November 1,2024 5:00 PM
9/20/2024 7:06:30 AM
• Tev.Holloman assigned the task to Tev.Holloman 9/26/2024 1:56:23 PM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Shamrock Forest
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)
Lot 1
NC Reference No.*
NCG01-2024-2926
Certificate of Coverage(COC)No.* Permit Version
NCC242926 1.00
Invoice Date 9/20/2024
Initial Invoice No. NCC242926-2024
Initial Fee $ 120.00
Invoice Due Date 10/20/2024
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 9/26/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 768862206
Transaction Number*
NOI Tracking No. 218676
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes

Project Tracking ID NCC-POLK-2024-Shamrock Forest