NCC192755_Annual Fee Payment Record_20201210

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 11/30/2020 4:37:52 PM (Workflow Start Event)
Submit by Selkane, Aziza 12/10/2020 9:18:30 AM (Annual Fee Payment Verification for NCC192755-2020)
* Brookberry Farm LLC
• Selkane, Aziza assigned the task to Selkane, Aziza 12/10/2020 9:17 AM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: January 11, 2021 5:00
PM 11 /30/2020 4:37 PM

NORTH CAROLINA
Environmental Quvllty
Certificate of NCC192755
Coverage (COC) This is passed fromtheworldlow when the invoice isfiled.
No.*
NC Reference COC NCG01-2019-2755
No.*
Permit Status: Active
Project Name* Brookberry Farm - Phase 8
Project Address* Brookberry Farm Circle, Winston-Salem, NC
Permittee * Brookberry Farm, LLC
County Forsyth
Invoice No. NCC192755-2020
This is passed fromthe worldlow when the invoice is filed.
Annual Fee * $ 100.00
Invoice Date* 12/1/2020
This is passed fromthe worldlow when the invoice is filed.
Invoice Due Date* 1/1/2021
This is passed fromthe worldlow when the invoice is filed.
An automated email reminder is sent to the permittee when the invoice is due. Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Important: If you change the choice below to Payment NOT RECEIVED, the fee status becomes PAST DUE, and the
permittee will receive a Notice of Deficiency.
Annual Fee Payment r Fee Payment Received or Not Applicable.
Received* r Fee Payment NOT RECEIVED.
Date Payment 12/10/2020
Received * Or, if WAIVBD or NOT FECBV®, this is the date that status is recorded.
Method of Payment* r electronic
r check
f other
Check Number* 4432
Fee Status* PAID
Legally Responsible Rodney Cheek
Person (Orig.)

Original Permittee E- [e-mail]
mail *
CONFIRM Permittee [e-mail]
E-mail * Opportunity to rrodify problem e-mail address or perrrittee contact info
Original Site Contact [e-mail]
E-mail *
CONFIRM Site [e-mail]
Contact E-mail * Opportunity to correct problem e-rrail address or site contact info
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 12/10/2020