NCG210355_Rtn Invoice_20191005

•
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY 1111111 I I I I II �I I I'll II� II�II I Ili 1�II1I IIII II
INVOICE * 2 0 1 9 P R 0 0 9 1 0 9 *
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. q6 -5
Invoice Number: 2019PR009109 e556 ( �6 f� Annual Fee Period: 2019-11-01 to 2020-10-31
Permit Number: NCG210355 II` Invoice Date: 10/03/2019
Wilkes County 1011,0
l 1 J 1( i"'�olw
Louisiana Pacific Corp v 0 0 Due Date: 11/02/2019
Roy Hart l(' Annual Fee: $100.00
Louisiana-Pacific Corporation I f Z 7 4 � N E 4 8 }3$i e i e S j 1 S
POBox98 `-ARD Ti,eYC E '`it' R TN TO S $`3 +`
Roaring River,NC 28669-0098 .1. 6.i8 AS T C O PO
Itk .WTLKES.SORO f C. 659-9 3Z
PE TURN N T E.P.:M.E;E;
Payment Options: '� 4
.i./1.lt€ �} iii{i l3:� la !!e ;i.9'„1
1. Electronic payment is convenient and quick. Tc 3 • ? a t a+t .1 i f,
browser. If you select eCheck,there will be no cc
convenience fee for a debit card is$3.95. You will receive a receipt immediately after 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 processi g fee will be charged
for returned checks in accordance with N.C.General Statute 25-3-5 2. 3 f 3 it
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 any questions,please contact the Fee Coordinator at(919)707-9220.
(Return This Portion With Check)
011111 1111111 011111 I II I I !II
* 2 0 1 9 P R 0 0 9 1 0 9 *
ANNUAL PERMIT INVOICE
Open
Invoice Number: 2019PR009109 Annual Fee Period: 2019-11-01 to 2020-10-31
Permit Number: NCG210355
Wilkes County Invoice Date: 10/3/2019
Louisiana Pacific Corp Due Date: 11/2/2019
Annual Fee: $100.00
Roy Hart
Louisiana-Pacific Corporation
PO Box 98 Check Number:
Roaring River,NC 28669-0098