NCG170417_Invoice returned_20191114

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY II I I II I 1111111 II 111111111
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INVOICE
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Annual Permit Fee Open
This annual fee is required by the North Carolina Administrative Code. It covers the administrative costs associated with
your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's
operating status. Failure to pay the fee by the due date will subject the permit to•revocation. Operating without a valid
permit is a violation and is subject to a$10,000 per day fine. If the permit is revoked and you later decide a permit is
needed,you must reapply,with the understanding the permit request may be denied due to changes in environmental,
regulatory, or modeling conditions.
Invoice Number: 2019PR0101514.3024,qq4 Annual Fee Period: 2019-12-01 to 2020-11-30nvoic
I e atePermit Number: NCG170417 r / Date: 11/05/2019
Lincoln County \?0 South Fork Industries,Inc. 1 Due Gate: 1L00.00 13`Everette J.Owens ( y2L—ll�i 11 W
South Fork Industries Inc D 8 1 1}' 1 4, 19 1
PO Box 1220 It 51 l'"
Lincolnton,NC 28093 _c °.R t_ TO SENDER
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NOT DELIVERABLE AS ADDRESSED ,
tUNABLE TO i ORWARO 1—
Payment Options: *fhSB@-01 0'�` -07'3 7
BC: 2769916 299
1. Electronic payment is convenient and quick. To p< ' 1,1
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browser. If you select eCheck,there will be no cones j i'j I ` j j} �� �i' ,� I`�j I j i'
convenience fee for a debit card is$3.95. You will receive a receipt immediately atter payment via email.
2. To pay by mail,please make your check payable to"DEMLR Stormwater Program"and include the invoice number on the check.
Then,detach the invoice below and write the check number on the invoice. A$25.00 processing fee will be charged
for returned checks in accordance with N.C.General Statute 25-3-512.
Remit payments by mail to:
NCDEQ-Division of Energy,Mineral and Land Resources.
Attn: Stormwater Billing
512 N.Salisbury Street
1612 Mail Service Center ,
Raleigh,NC 27699-1612
3. Non-payment of this fee by the payment due date will initiate the permit revocation process.
4. Please include your permit number in all correspondence.
5. Should you have: ,+ '; -,tact the Fee Coordinator at(919)707-9220.,
w.f, 4.ac.artvns,pease cuT,:
(Return This Portion With Check)
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ANNUAL PERMIT INVOICE
Open
Invoice Number: 2019PR010151 Annual Fee Period: 2019-12-01 to 2020-11-30
Permit Number: NCG170417
Lincoln County Invoice Date: 11/5/2019
South Fork Industries,Inc. Due Date: 12/5/2019
Annual Fee: $100.00
• Everette J.Owens
South Fork Industries Inc
PO Box 1220 Check Number:
Lincolnton, NC 28093