NCC216615_NOI 73883 Payment Verification_20211130

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/24/2021 10:04:18 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/24/2021 10:12:30 AM (Review - Construction NOI 73883)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/24/2021 10:05 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 26, 2021 5:00
PM 11/24/2021 10:05 AM
Submit by Selkane, Aziza 11/30/2021 12:55:34 PM (Payment Verification for NCC216615)
F Carillon Assisted Living
• Selkane, Aziza assigned the task to Selkane, Aziza 11/30/2021 12:54 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 5, 2022 5:00 PM
11 /24/2021 10:12 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Calyx Senior Living Fuquay-Varina
Lot Numbers
(If listed on the eNOI)
(all one project lot)
NC Reference No.*
NCG01-2021-6615
Certificate of
NCC216615
Coverage (COC) No.*
Invoice Date
11/24/2021
Initial Invoice No.
NCC216615-2021
Initial Fee
$ 100.00
Invoice Due Date
12/24/2021
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
11/30/2021
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
30326
NOI Tracking No.
73883
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-WAKE-2021-Calyx Senior Living Fuquay-Varina