NCC216806_NOI 75163 Payment Verification_20211209

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/7/2021 1:27:35 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 12/8/2021 9:19:16 AM (Review - Construction NOI 75163)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 12/7/2021 1:27 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 9, 2021 5:00
PM 12/7/2021 1:27 PM
Submit by Evans, Shaundra M 12/9/2021 8:08:08 AM (Payment Verification for NCC216806)
* Christopher Latta
• Evans, Shaundra M assigned the task to Evans, Shaundra M 12/9/2021 8:07 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 19, 2022 5:00 PM
12/8/2021 9:19 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Lee Park Church Baseball Field
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2021-6806
Certificate of NCC216806
Coverage (COC) No.*
Invoice Date 12/8/2021
Initial Invoice No. NCC216806-2021
Initial Fee $ 100.00
Invoice Due Date 1/7/2022
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 12/9/2021
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 606934681
Transaction Number*
NOI Tracking No. 75163
Tracking ID referenced upon submittal
This is an Express • No
Review Project Yes
Project Tracking ID NCC-UNION-2021-Lee Park Church Baseball Field