NCC216296_NOI 72825 Payment Verification_20211115

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/9/2021 3:33:21 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/10/2021 7:39:56 AM (Review - Construction NOI 72825)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/9/2021 3:33 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 11, 2021 5:00
PM 11/9/2021 3:33 PM
Submit by Evans, Shaundra M 11/15/2021 8:13:26 AM (Payment Verification for NCC216296)
F Miles Wright
• Evans, Shaundra M assigned the task to Evans, Shaundra M 11/15/2021 8:12 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 22, 2021 5:00
PM 11/10/2021 7:40 AM

5 A7
Payment Verification
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Country Place
Lot Numbers
(If listed on the eNOI)
2,3,4,8,9,11,12,13,14,15,26,27,28 & 29
NC Reference No.*
NCG01-2021-6296
Certificate of
NCC216296
Coverage (COC) No.*
Invoice Date
11/10/2021
Initial Invoice No.
NCC216296-2021
Initial Fee
$ 100.00
Invoice Due Date
12/10/2021
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
11/15/2021
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
602623074
Transaction Number*
NOI Tracking No.
72825
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-BURKE-2021-Country Place