NCC220457_Annual Fee Payment Record (2025 Fee)_20250115

Action History(UTC-05:00)
by Workflow 12/27/2024 1:37:07 PM (Workflow Start Event)
Submit by Kieu Tran 1/15/2025 12:57:54 PM (2025 Annual Fee Payment Verification for NCC220457-2025)
0 COC Rescinded
• The task was assigned to DEMLR NCG01 Annual Fee Team.The due date is: February 7,2025 5:00
PM 12/27/2024 1:37:07 PM
• Kieu Tran assigned the task to Kieu Tran 1/15/2025 12:57:21 PM

2025 Annual Fee Payment Verification
NORTH CAROLINA
Environmental Quality
Certificate of NCC220457
Coverage(COC)No.* This is passed from the workflow when the invoice is filed.
NC Reference COC NCG01-2022-0457
No.*
Permit Status: INACTIVE
Already Rescinded: 1/15/2025
This field appears if the permit has already been terminated.
This COC has been rescinded(fee waive option is available).
Expiration Date 3/31/2029
Year COC Issued 2022
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
2023 Fee Status 2024 Fee Status
PAID PAID
WAIVE FEE?* Yes, Payment Not Applicable
No, Payment Still Applies
Project Name* Cliffdale Woods Subdivision-SFD lots
Project Address* Bismarck Court,Winston Salem, NC
Permittee* Clayton Properties Group Inc dba Mungo Homes
County Forsyth
Invoice No.* NCC220457-2025
This is passed from the workflow when the invoice is filed.
Annual Fee* $ 120.00
Invoice Date* 1/1/2025
This is passed from the workflow when the invoice is filed.
Invoice Due Date* 2/1/2025
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.
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 1/15/2025
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 Connie Ader
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. 336-823-0275
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- Cliffdale Woods Subdivision-SFD lots
day Reminder The project name is passed from workflow for the 30-day reminder
Permittee Name for Clayton Properties Group Inc dba Mungo Homes
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* 1/15/2025

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