NCG160072_Rtn Invoice_20200713

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY II I I II I I II II I I II III I I I III II II
INVOICE * 2020 PROD 5967 *
Stormwater Annual Permit Fee Open
This Stormwater annual fee is required by the North Carolina Administrative Code 143-215.D(a). It covers the administrat
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 lat
decide a permit is needed, you must reapply, with the understanding the permit request may be denied due to changes it
environmental, regulatory, or modeling conditions.
Invoice Number: 2020PR005967 Annual Fee Period: 2020-08-01 to 2021-07-31
Permit Number: NCG160072 Invoice Date: 07/03/2020
Guilford County
Blythe Construction Inc-Plt#1 Due Date: 08/02/2020
Jim Crocker Annual Fee: $100.00
Blythe Construction Inc
2083 Bishop Rd
Greensboro, NC 27402
Payment Options:
1. Electronic payment is convenient and quick. To pay by ePayment,type"https://deq.nc.gov/epayments/stormwater"into your
browser. If you select eCheck,there will be no convenience fee. The convenience fee for a credit card is 2.65%and the
convenience fee for a debit card is$3.95.
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 Sta+..*,,
Remit payments by mail to: 7 S pi= I v�% 2 8
c/ID LJhOR TT.'119C C Y.C? ,7 TA_j T r9 CF NFL..
NCDEQ-Division of Energy, Mineral and Land B L YTH E CONS TR'ti C TI ON
Attn: Stormwater Billing d v v v T Tl Nil.1\i is Ti Ii :a 1I.. .`st
512N.SalisburyStreet GRcEENSBORO NC 27 406-63 5i
1612 Mail Service Center aR tL . S
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Raleigh, NC 27699-1612 a ii�13+1�) ))�11�.:i�i�.ia�a�I��I.litiil�.:il��fllt,iit111i BdiJP7.f illF
3. Non-payment of this fee by the payment due date will init
4. Please include your permit number in all correspondence.
5. Should you have any questions, please contact the Fee Coordinator at(919)707-9220.
. . vr+t v L�LJ—
(Return This Portion With Check)
11121 1112111 III II II I I I I I I II11
LAND QUALITY SECTION P R 0 0 5 9 6 7 *
ANNUAL PERMIT INVOICE
Open
Invoice Number: 2020PR005967 Annual Fee Period: 2020-08-01 to 2021-07-31
Permit Number: NCG160072
Guilford County Invoice Date: 7/3/2020
Blythe Construction Inc-Plt#1 Due Date: 8/2/2020
Annual Fee: $100.00
Jim Crocker
Blythe Construction Inc
2083 Bishop Rd Check Number:
Greensboro, NC 27402