NCC215183_Annual Fee Payment Record (2024 Fee)_20241008

Action History (UTC-05:00)Eastern Time(US&Canada)
by Workflow 8/30/2024 7:59:57 AM (Workflow Start Event)
Submit by Kieu Tran 10/8/2024 1:55:05 PM (2024 Annual Fee Payment Verification for NCC215183-2024)
0 COC Rescinded
• The task was assigned to DEMLR NCG01 Annual Fee Team.The due date is: October 11,2024 5:00
PM 8/30/2024 7:59:57 AM
• Kieu Tran assigned the task to Kieu Tran 10/8/2024 1:54:46 PM

2024 Annual Fee Payment Verification
NORTH CAROLINA
Environmental Quality
Certificate of NCC215183
Coverage(COC)No.* This is passed from the workflow when the invoice is filed.
NC Reference COC NCG01-2021-5183
No.*
Permit Status: INACTIVE
Already Rescinded: 10/8/2024
This field appears if the permit has already been terminated.
Expiration Date 3/31/2029
Year COC Issued 2021
This field will be hidden.
Check previous years for outstanding fees(years that do not apply will be blank):
2020 Fee Status 2021 Fee Status 2022 Fee Status
PAID
2023 Fee Status
PAID
WAIVE FEE?* Yes, Payment Not Applicable
No, Payment Still Applies
Project Name* Villas at Jefferson Ridge
Project Address* Albemarle Court,Winston-Salem, NC
Permittee* Nova Jefferson, LLC
County Forsyth
Invoice No.* NCC215183-2024
This is passed from the workflow when the invoice is filed.
Annual Fee* $ 120.00
Invoice Date* 9/1/2024
This is passed from the workflow when the invoice is filed.
Invoice Due Date* 10/1/2024
This is passed from the workflow when the invoice is filed.
An automated email reminder is sent to the permittee when the invoice is due.Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Days Overdue 7
Wait at least 15 days until proceeding to NOD.
Important: If you change the choice below to Payment NOT RECEIVED,the fee status becomes PAST DUE,and the
permittee will receive a Notice of Deficiency.

Annual Fee Payment Fee Payment Received or Not Applicable.
Received* Fee Payment NOT RECEIVED.
Date Payment 10/8/2024
Received* Or,if WAIVED or NOT RECEIVED,this is the date that status is recorded.
ePayment
Transaction Number*
Check Number*
Fee Status* WAIVED
Legally Responsible Andrew Dreyfuss
Person(Orig.)
Permittee E-mail* [e-mail]
CONFIRM Permittee [e-mail]
E-mail* Opportunity to modify problem e-mail address or permittee contact info
Site Contact E-mail* [e-mail]
CONFIRM Site [e-mail]
Contact E-mail* Opportunity to correct problem e-mail address or site contact info
Billing E-mail [e-mail]
(If available)
CONFIRM Billing E- [e-mail]
mail Opportunity to correct problem e-mail address or billing contact info
Billing Telephone No. [phone]
Permittee Email for [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow).
Site Contact Email for [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow)
Billing Contact Email [e-mail]
for 30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow).
Project Name for 30- Villas at Jefferson Ridge
day Reminder The project name is passed from workflow for the 30-day reminder
Permittee Name for Nova Jefferson, LLC
30-day Reminder The permittee is passed from workflow for the 30-day reminder
County for 30-day Forsyth
Reminder The county is passed from workflow for the 30-day reminder
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date* 10/8/2024

I I