NCC222638_NOI 97967 Payment Verification_20220725

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/20/2022 2:03:00 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 7/21/2022 8:16:03 AM (Review - NOI 97967 McDonald's #32-0302)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 7/20/2022 2:03 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: July 25, 2022 5:00 PM
7/20/2022 2:03 PM
by Workflow 7/21/2022 8:16:16 AM (Workflow Start Event)
Submit by Tran, Kieu M 7/25/2022 1:52:39 PM (Payment Verification for NCC222638)
F Jennifer Bardeschewski
• Tran, Kieu M assigned the task to Tran, Kieu M 7/25/2022 1:52 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: September 1, 2022 5:00 PM
7/21/2022 8:16 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
McDonald's #32-0302
Lot Numbers
(If listed on the eNOI)
Tax Lot 130
NC Reference No.*
NCG01-2022-2638
Certificate of
NCC222638
Coverage (COC) No.*
Invoice Date
7/21/2022
Initial Invoice No.
NCC222638-2022
Initial Fee
$ 100.00
Invoice Due Date
8/20/2022
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
7/25/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
644374266
Transaction Number*
NOI Tracking No.
97967
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-FORSY-2022-McDonald's #32-0302