NCC202352_Annual Fee Payment Record_20210621

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 5/28/2021 9:15:27 AM (Workflow Start Event)
Submit by McCoy, Suzanne 6/21/2021 8:30:00 AM (2021 Annual Fee Payment Verification for NCC202352-2021)
Mark IN McAm
McCoy, Suzanne assigned the task to McCoy, Suzanne 6/21/2021 8:29 AM
The task was assigned to DEMLR NCGOII Annual Fee Team. The due date is: July 9, 2021 5:00 PM
5/28/2021 9:15 AM

Li Annuai i�ee
NORT. c (DLINA
Enyirmm�tal Quallty
Certificate of
NCC202352
Coverage (COC)
This is passed frornthe worldlow when the invoice is filed.
No. *
NC Reference COC
NCGOl-2020-2352
No. *
Permit Status:
Active
Year COC Issued
2020
This field will be hidden.
2020 Fee Status
Check last year's f ee status
Project Name*
Rolesville Crossfit
Project Address
850 Granite Falls Blvd, Rolesville, NC
Pe rmitte e
McArn Realty, LLC
County
Wake
Invoice No.*
NCC202352-2021
This is passed frornthe workflow when the invoice is filed.
AnnualFee
$ 100.00
Invoice Date*
6/1/2021
This is passed frornthe workflow when the invoice is filed.
Invoice Due Date*
7/11/20211
This is passed frornthe 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 WII receive a Notice of Deficiency.
Annual Fee Payment r Fee Payment Received or Not Applicable.
Received* r Fee Payment NOT RECEIVED.
Date Payment 6/21/2021
Received * Or, if WAIVBDor NOTFECBVED, this is the date that status is recorded.
Method of Payment* r electronic
r check
r other
Check Number* 1532
Fee Status* PAID

Legally Responsible Mark McArn
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
Original Billing E- (If available)
mail
CONFIRM Billing E- Opportunity to correct problem e-n-ail address or billing contact info
mail
Billing Telephone
No.
Permittee Email for [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed (passed fromworldlow).
Site Contact Email [e-mail]
for 30-day Reminder This is the errail for the 30-day reminder if needed (passed fromworldlow)
Billing Contact Email This is theen-ailforthe3G-day reminderif needed (passed fromworldlow).
for 30-day Reminder
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 6/21/2021