NCG080784_Rtn Inv_20200123

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY II I I II I I II II I I II II II I 1111111
INVOICE * 2 0 2 0 P R 0 0 0 2 2 3 *
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: 2020PR000223 /'� J iIf1—0 1 a Annual Fee Period: 2020-02-01 to 2021-01-31
Permit Number: NCG080784 �d Invoic Date: 01/07/2020
Washington County 6- li 5 �ofc�/f
Republic Services of NC, LC-GDS ym ut �� D Date. 02/06/2020
Candy Sanders Annual Fee: $100.00
Republic Services of North Carolina LLC
POBox1527 T,XIE 276 FE 1 0303/23/2
Washington,NC 27889-1527
RETURN TO SENDER
NOT OEUNAELE ELE AS,TO FORWARD
ADDRESSED
Payment Options:
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1. Electronic payment is convenient and q ' , ,° ,t.a° m . _ . F•
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browser. If you select eCheck,there will b e! !` `£ s tat _ e, s 4
convenience fee for a debit card is$3.95.1 _
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 any questions,please contact the Fee Coordinator at(919)707-9220.
(Return This Portion With Check)
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ANNUAL PERMIT INVOICE
Open
Invoice Number: 2020PR000223 Annual Fee Period: 2020-02-01 to 2021-01-31
Permit Number: NCG080784
Washington County Invoice Date: 1/7/2020
Republic Services of NC,LLC-GDS-Plymouth Due Date: 2/6/2020
Annual Fee: $100.00
Candy Sanders
Republic Services of North Carolina LLC
PO Box 1527 Check Number:
Washington,NC 27889-1527