NCC203603_Annual Fee Payment Record_20210810

Action History (UTC-05:00)Eastern Time(US&Canada)
by Workflow 7/29/2021 6:18:42 PM(Workflow Start Event)
Submit by Morman,Alaina 8/10/2021 12:02:38 PM(2021 Annual Fee Payment Verification for NCC203603-2021)
p NOT approved 811012021.
• Morman,Alaina assigned the task to Morman,Alaina 8/10/2021 10:27 AM
• The task was assigned to DEMLR NCG01 Annual Fee Team.The due date is: September 9,2021 5:00
PM 7/29/2021 6:18 PM

2021 Annual Fee Payrnent •
NORTH CAROLINA
Environmental Quvllty
Certificate of NCC203603
Coverage (COC) This is passed fromthe workflow when the invoice isfiled.
No.*
NC Reference COC NCG01-2020-3603
No.*
Permit Status: INACTIVE
Already Rescinded: 8/10/2021
This field appears if the permt has already been termnated.
Year COC Issued 2020
This field will be hidden.
2020 Fee Status Check last year's fee status
WAIVE FEE?* IT Yes, Payment Not Applicable
f No, Payment Still Applies
Project Name* Southern Crossroads Ralph Stephens Rd. Sidewalk
Project Address* 2051 Ralph Stephens Road, Holly Springs, NC
Permittee* Southern Crossroads, Inc.
County Wake
Invoice No. NCC203603-2021
This is passed fromthe workflow when the invoice is filed.
Annual Fee* $ 100.00
Invoice Date* 8/1/2021
This is passed fromthe workflow when the invoice is filed.
Invoice Due Date* 9/1/2021
This is passed from the workflow 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 IT Fee Payment Received or Not Applicable.
Received* r Fee Payment NOT RECEIVED.
Date Payment 8/10/2021
Received* Or,if WAN®or NOT F ECBV®,this is the date that status is recorded.

e Payme nt
Transaction
Number*
Check Number*
Fee Status* WAIVED
Legally Responsible Brantley Powell
Person (Orig.)
Original Permittee E- [e-mail]
mail*
CONFIRM Permittee [e-mail]
E-mail* Opportunity to rrodify probleme-rrail address or permttee contact info
Original Site Contact [e-mail]
E-mail*
CONFIRM Site [e-mail]
Contact E-mail* Opportunity to correct probleme-rail address or site contact info
Original Billing E- (It available)
mail
CONFIRM Billing E- Opportunity to correct probleme-mail address or billing contact info
mail
Billing Telephone
No.
Permittee Email for [e-mail]
30-day Reminder This is the email for the 3aday reninder if needed(passed fromworldlow).
Site Contact Email [e-mail]
for 30-day Reminder This is the email for the 30-day reminder if needed(passed fromworldlow)
Billing Contact Email This is the en-ail for the 3Qday reminder if needed(passed from worldlow).
for 30-day Reminder
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date* 8/10/2021