NCC215869_NOI 69184 Payment Verification_20211025

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/20/2021 8:58:13 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/20/2021 9:01:45 AM (Review - Construction NOI 69184)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/20/2021 8:58 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 22, 2021 5:00
PM 10/20/2021 8:58 AM
Submit by Evans, Shaundra M 10/25/2021 7:57:42 AM (Payment Verification for NCC215869)
F Lorraine Rivera
• Evans, Shaundra M assigned the task to Evans, Shaundra M 10/25/2021 7:57 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 1, 2021 5:00 PM
10/20/2021 9:01 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Anderson Creek Crossing Phase 8 ( Lots # 59,205-210, and 215)
Lot Numbers
(If listed on the eNOI)
59 , 205, 206 , 207, 208, 209, 210, 215
NC Reference No.*
NCG01-2021-5869
Certificate of
NCC215869
Coverage (COC) No.*
Invoice Date
10/20/2021
Initial Invoice No.
NCC215869-2021
Initial Fee
$ 100.00
Invoice Due Date
11/19/2021
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*
• Payment Received.
Payment NOT RECEIVED.
Payment Status
PAID
Date Payment
10/25/2021
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
599050363
Transaction Number*
NOI Tracking No.
69184
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-HARNE-2021-Anderson Creek Crossing Phase 8 ( Lots # 59,205-210, and
215)