NCC214270_NOI 59672 Payment Verification_20210726

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 7/22/2021 1:30:42 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 7/23/2021 7:50:07 AM (Review- Construction NOI 59672)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 7/22/2021 1:31 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: July 26, 2021 5:00 PM
7/22/2021 1:31 PM
Submit by Selkane, Aziza 7/26/2021 9:04:36 AM (Payment Verification for NCC214270)
* Sarah C Mardam-Bey
• Selkane, Aziza assigned the task to Selkane, Aziza 7/26/2021 9:01 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: September 3, 2021 5:00
PM 7/23/2021 7:50 AM

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•
V.
• yrnent Verification
NORTH CAROLINA
Envtro me tufQuuftty
Project Name
Hampton Inn - Mosaic
Lot Numbers
(If listed on the eN01)
PIN# 94075 / Lot 8
NC Reference No.*
NCG01-2021-4270
Certificate of
NCC214270
Coverage (COC)
No.*
Invoice Date
7/23/2021
Initial Invoice No.
NCC214270-2021
Initial Fee
$ 100.00
Invoice Due Date
8/22/2021
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 eNOI at this step.
Payment Received* r Payment Received.
r Payment NOT RECEIVED.
Payment Status
PAID
Date Payme nt
7/26/2021
Received*
(Or, if not received, date rejected for no payrrent)
Method of Payment*
r electronic
r check
r Other
ePayment
583832529
Transaction
Number*
NOI Tracking No.
59672
Tracking ID referenced upon subrrittal
This is an Express
r No
Review Project
r Yes
Project Tracking ID
NCC-CHATI -2021-Hampton Inn - Mosaic