NCC205305_Annual Fee Payment Record_20211207

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 11/29/2021 5:36:54 PM (Workflow Start Event)
Submit by Selkane, Aziza 12/7/2021 4:14:14 PM (2021 Annual Fee Payment Verification for NCC205305-2021)
0 City of Greensboro North Carolina
• Selkane, Aziza assigned the task to Selkane, Aziza 12/7/2021 4:13 PM
• The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: January 10, 2022 5:00
PM 11/29/2021 5:36 PM

51A-
1 •
NORTH CAROLINA
Environmental Quallty
Certificate of NCC205305
Coverage (COC) No. * This is passed from the workflow when the invoice is filed.
NC Reference COC NCG01-2020-5305
No.*
Permit Status:
Active
Year COC Issued
2020
This field will be hidden.
2020 Fee Status
Check last year's fee status
Project Name*
NCC-GUILF-2021-Contract 2018-051A, Davie Street Streetscape Improvements
Project Address *
200 N. to 339 S. Davie Street, Greensboro, NC
Permittee*
City of Greensboro
County
Guilford
Invoice No.*
NCC205305-2021
This is passed from the workflow when the invoice is filed.
Annual Fee*
$ 100.00
Invoice Date*
12/1/2021
This is passed from the workflow when the invoice is filed.
Invoice Due Date*
1/1/2022
This is passed from the workflow when the invoice is filed.
An automated email reminder is sent to the permittee when the invoice is due. Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Important: If you change the choice below to Payment NOT RECEIVED, the fee status becomes PAST DUE, and the
permittee will receive a Notice of Deficiency.
Annual Fee Payment Fee Payment Received or Not Applicable.
Received* Fee Payment NOT RECEIVED.
Date Payment 12/7/2021
Received * Or, if WAIVED or NOT RECEIVED, this is the date that status is recorded.
Method of Payment* electronic
check
other
Check Number* 452031
Fee Status* PAID

Legally Responsible John Fersner
Person (Orig.)
Original Permittee E- [e-mail]
mail *
CONFIRM Permittee [e-mail]
E-mail * Opportunity to modify problem e-mail address or permittee contact info
Original Site Contact Melinda. [e-mail]
E-mail *
CONFIRM Site Melinda. [e-mail]
Contact E-mail * Opportunity to correct problem e-mail address or site contact info
Original Billing E-mail (If available)
CONFIRM Billing E- Opportunity to correct problem e-mail address or billing contact info
mail
Billing Telephone No.
Permittee Email for [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed (passed from workflow)
Site Contact Email for Melinda. [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed (passed from workflow)
Billing Contact Email This is the email for the 30-day reminder if needed (passed from workflow).
for 30-day Reminder
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 12/7/2021