NCC223269_NOI 105627 Payment Verification_20220919

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/15/2022 4:49:48 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 9/16/2022 6:54:34 AM (Review - NOI 105627 LO 51 Perry Farms PH3)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/15/2022 4:50 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 20, 2022 5:00
PM 9/15/2022 4:50 PM
by Workflow 9/16/2022 6:54:41 AM (Workflow Start Event)
Submit by Holloman, Tevye L 9/19/2022 9:40:14 AM (Payment Verification for NCC223269)
F Parker Stone
Holloman, Tevye L assigned the task to Holloman, Tevye L 9/19/2022 9:39 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 28, 2022 5:00 PM
9/16/2022 6:54 AM

5 A7
Payment Verification
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
LO 51 Perry Farms PH3
Lot Numbers
(If listed on the eNOI)
51
NC Reference No.*
NCG01-2022-3269
Certificate of
NCC223269
Coverage (COC) No.*
Invoice Date
9/16/2022
Initial Invoice No.
NCC223269-2022
Initial Fee
$ 100.00
Invoice Due Date
10/16/2022
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
9/19/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
653512934
Transaction Number*
NOI Tracking No.
105627
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-WAKE-2022-LO 51 Perry Farms PH3