NCC216165_NOI 72389 Payment Verification_20211129

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/4/2021 8:32:41 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/4/2021 9:29:53 AM (Review - Construction NOI 72389)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/4/2021 8:33 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 8, 2021 5:00
PM 11/4/2021 8:33 AM
Submit by Evans, Shaundra M 11/29/2021 8:19:27 AM (Payment Verification for NCC216165)
F Kristi Anspach
• Evans, Shaundra M assigned the task to Evans, Shaundra M 11/29/2021 8:18 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 16, 2021 5:00
PM 11/4/2021 9:30 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Beverly Lots 12,18,19, 20, 21, 22, 23, 24, 25, 26, 29, 30, 32, 33, 34, 35, 38
Lot Numbers
(If listed on the eNOI)
12, 18,19, 20, 21, 22, 23, 24, 25, 26, 29, 30, 32, 33, 34, 35, 38
NC Reference No.*
NCG01-2021-6165
Certificate of
NCC216165
Coverage (COC) No.*
Invoice Date
11/4/2021
Initial Invoice No.
NCC216165-2021
Initial Fee
$ 100.00
Invoice Due Date
12/4/2021
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
11/29/2021
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
604603307
Transaction Number*
NOI Tracking No.
72389
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-JOHNS-2021-Beverly Lots 12,18,19, 20, 21, 22, 23, 24, 25, 26, 29, 30, 32, 33,
34, 35, 38