NCC204727_NOI 33278 Payment Verification_20201021

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/16/2020 3:53:18 PM (NCG01 NOI Submission)
Approve by Clark, Paul 10/20/2020 8:24:56 AM (Review- Construction NOI 33278)
• The task was assigned to Clark, Paul by round robin distribution 10/16/2020 3:54 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 20, 2020 5:00
PM 10/16/2020 3:54 PM
Submit by Selkane, Aziza 10/21/2020 10:24:42 AM (Payment Verification for NCC204727)
* Cynthia Jacobs
• Selkane, Aziza assigned the task to Selkane, Aziza 10/21/2020 10:24 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 1, 2020 5:00
PM 10/20/2020 8:25 AM

SfA7$ q,
•
V.
• yrnent Verification
NORTH CAROLINA
Envlro me tufQuuftty
Project Name
Forest Oaks Phase 5 - Lots 263, 315, 316 & 317
NC Reference No.*
NCG01-2020-4727
Certificate of
NCC204727
Coverage (COC)
No. *
Invoice Date
10/20/2020
Initial Invoice No.
NCC204727-2020
Initial Fee
$ 100.00
Invoice Due Date
11/19/2020
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 eNO1 at this step.
Payment Received* r Payment Received.
r Payment NOT RECEIVED.
Payment Status
PAID
Date Payme nt
10/21 /2020
Received *
(Or, if not received, date rejected for no payrrent)
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
f Other
ePayment
540945539
Transaction
Number*
NOI Tracking No.
33278
Tracking ID referenced upon subrrittal
This is an Express
r No
Review Project
r Yes
Project Tracking ID
NCC-HARNE-2020-Forest Oaks Phase 5 - Lots 263, 315, 316 & 317