NCC215961_NOI 69926 Payment Verification_20211027

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/26/2021 8:51:04 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/26/2021 9:12:29 AM (Review - Construction NOI 69926)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/26/2021 8:51 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 28, 2021 5:00
PM 10/26/2021 8:51 AM
Submit by Evans, Shaundra M 10/27/2021 8:41:52 AM (Payment Verification for NCC215961)
F Timothy S Bennett
• Evans, Shaundra M assigned the task to Evans, Shaundra M 10/27/2021 8:41 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 7, 2021 5:00 PM
10/26/2021 9:12 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Creekside Lot 4
Lot Numbers
(If listed on the eNOI)
Lot #4
NC Reference No.*
NCG01-2021-5961
Certificate of
NCC215961
Coverage (COC) No.*
Invoice Date
10/26/2021
Initial Invoice No.
NCC215961-2021
Initial Fee
$ 100.00
Invoice Due Date
11/25/2021
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
10/27/2021
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
599671347
Transaction Number*
NOI Tracking No.
69926
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-NEW H-2021-Creekside Lot 4