NCC201900_Payment Verification_20200513

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/6/2020 9:50:14 AM (NCG01 NOI Submission)
Approve by Garcia, Lauren V 5/8/2020 12:34:06 PM (Review- Construction NOI 25201)
. The task was assigned to Garcia, Lauren V by round robin distribution 5/6/2020 9:51 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: May 8, 2020 5:00 PM
5/6/2020 9:51 AM
Submit by McCoy, Suzanne 5/13/2020 7:44:18 AM (Payment Verification for NCC201900)
* Brian Wildschuetz
• McCoy, Suzanne assigned the task to McCoy, Suzanne 5/13/2020 7:43 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: June 19, 2020 5:00 PM
5/8/2020 12:34 PM

NORTH CAROLINA
Environmental Quvllly
Project Tracking ID*
NCC-WAKE-2020-Shelbourne Senior Living
NC Reference No.*
NCG01-2020-1900
Certificate of
NCC201900
Coverage (COC)
No.*
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*
r Payment Received.
r Payment NOT RECEIVED.
Date Payment
5/13/2020
Received*
Method of Payment*
r electronic
f check
r NO PAYMENT RECEIVED
f Other
ePayment
517041251
Transaction
Number*
NOI Tracking No.
25201
Tracking ID referenced upon subrrittal
This is an Express
r No
Review Project
r Yes