NCC216000_NOI 70220 Payment Verification_20211028

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/27/2021 8:33:53 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/27/2021 8:59:30 AM (Review - Construction NOI 70220)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/27/2021 8:35 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 29, 2021 5:00
PM 10/27/2021 8:35 AM
Submit by Evans, Shaundra M 10/28/2021 7:53:52 AM (Payment Verification for NCC216000)
F Roger M Bartlett
• Evans, Shaundra M assigned the task to Evans, Shaundra M 10/28/2021 7:53 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 8, 2021 5:00 PM
10/27/2021 8:59 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Hospice House Foundation of WNC
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2021-6000
Certificate of NCC216000
Coverage (COC) No.*
Invoice Date 10/27/2021
Initial Invoice No. NCC216000-2021
Initial Fee $ 100.00
Invoice Due Date 11/26/2021
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 10/28/2021
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 599818996
Transaction Number*
NOI Tracking No. 70220
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-MACON-2021-Hospice House Foundation of WNC