NCC217118_NOI 76282 Payment Verification_20211222

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/21/2021 9:26:59 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 12/21/2021 9:46:52 AM (Review - Construction NOI 76282)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 12/21/2021 9:27 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 23, 2021 5:00
PM. The priority is: High 12/21/2021 9:27 AM
Submit by Evans, Shaundra M 12/22/2021 8:01:19 AM (Payment Verification for NCC217118)
P Kristyna Moore
• Evans, Shaundra M assigned the task to Evans, Shaundra M 12/22/2021 8:00 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: February 1, 2022 5:00 PM.
The priority is: High 12/21/2021 9:46 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name West Jefferson Retail Store
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2021-7118
Certificate of NCC217118
Coverage (COC) No.*
Invoice Date 12/21/2021
Initial Invoice No. NCC217118-2021
Initial Fee $ 100.00
Invoice Due Date 1/20/2022
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 12/22/2021
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 609145910
Transaction Number*
NOI Tracking No. 76282
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-ASHE-2021-West Jefferson Retail Store