NCC193004_Annual Fee Payment Record_20210106

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 12/7/2020 5:17:48 PM (Workflow Start Event)
Submit by McCoy, Suzanne 1/6/2021 9:28:08 AM (Annual Fee Payment Verification for NCC193004-2020)
p Golden Triangle # 5 Providence Square LLc
• McCoy, Suzanne assigned the task to McCoy, Suzanne 1/6/2021 9:27 AM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: January 18, 2021 5:00
PM 12/7/2020 5:17 PM

NORTH CAROLINA
Environmental Quvllty
Certificate of NCC193004
Coverage (COC) This is passed fromtheworldlow when the invoice isfiled.
No.*
NC Reference COC NCG01-2019-3004
No.*
Permit Status: Active
Project Name* Providence Square Renovation
Project Address* 5660 International Drive, Charlotte, NC
Permittee * Golden Triangle #5 - Providence Square, LLC.
County Mecklenburg
Invoice No.* NCC193004-2020
This is passed fromthe worldlow when the invoice is filed.
Annual Fee * $ 100.00
Invoice Date* 12/8/2020
This is passed fromthe worldlow when the invoice is filed.
Invoice Due Date* 1/8/2021
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 1/6/2021
Received * Or, if WANBD or NOT FECBV®, this is the date that status is recorded.
Method of Payment* r electronic
r check
f other
Check Number* 125
Fee Status* PAID
Legally Responsible Daniel Levine
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-mail address or site contact info
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 1/6/2021