NCC221710_NOI 90251 Payment Verification_20220518

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/2/2022 12:50:01 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 5/3/2022 7:09:36 AM (Review - NOI 90251 4 Middlebury Ct)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 5/2/2022 12:50 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: May 5, 2022 5:00 PM
5/2/2022 12:50 PM
by Workflow 5/3/2022 7:09:43 AM (Workflow Start Event)
Submit by Selkane, Aziza 5/18/2022 7:19:19 AM (Payment Verification for NCC221710)
F Latitude Builders LLC
• Selkane, Aziza assigned the task to Selkane, Aziza 5/18/2022 7:18 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: June 14, 2022 5:00 PM
5/3/2022 7:09 AM

5 A7
Payment Verification
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
4 Middlebury Ct
Lot Numbers
(If listed on the eNOI)
NC Reference No.*
NCG01-2022-1710
Certificate of
NCC221710
Coverage (COC) No.*
Invoice Date
5/3/2022
Initial Invoice No.
NCC221710-2022
Initial Fee
$ 100.00
Invoice Due Date
6/2/2022
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
5/18/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
• check
Other
Check Number*
4028
NOI Tracking No.
90251
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-MOORE-2022-4 Middlebury Ct