NCC223251_NOI 105520 Payment Verification_20220916

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/14/2022 2:36:29 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 9/15/2022 7:01:37 AM (Review - NOI 105520 Lot 120 Lissara)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/14/2022 2:36 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 19, 2022 5:00
PM 9/14/2022 2:36 PM
by Workflow 9/15/2022 7:01:45 AM (Workflow Start Event)
Submit by Holloman, Tevye L 9/16/2022 12:14:42 PM (Payment Verification for NCC223251)
F Bryan Elliott
Holloman, Tevye L assigned the task to Holloman, Tevye L 9/16/2022 12:14 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 27, 2022 5:00 PM
9/15/2022 7:01 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Lot 120 Lissara
Lot Numbers
(If listed on the eNOI)
120
NC Reference No.*
NCG01-2022-3251
Certificate of
NCC223251
Coverage (COC) No.*
Invoice Date
9/15/2022
Initial Invoice No.
NCC223251-2022
Initial Fee
$ 100.00
Invoice Due Date
10/15/2022
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
9/16/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
653262414
Transaction Number*
NOI Tracking No.
105520
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-FORSY-2022-Lot 120 Lissara