NCC223230_NOI 105002 Payment Verification_20220920

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/8/2022 2:05:02 PM (NCG01 NOI Submission)
Approve by Clark, Paul B 9/13/2022 2:50:50 PM (Review - NOI 105002 Jackson Pond Lots 3,6,8,9,10,14-16,18-20,
22, 24-26, 28, 30-32 & 34)
• Clark, Paul B reassigned the task to Clark, Paul B 9/8/2022 4:01 PM
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/8/2022 2:05 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 13, 2022 5:00
PM 9/8/2022 2:05 PM
by Workflow 9/13/2022 2:51:01 PM (Workflow Start Event)
Submit by Holloman, Tevye L 9/20/2022 11:02:46 AM (Payment Verification for NCC223230)
* Hilliard Engineering PLLC
• Holloman, Tevye L assigned the task to Holloman, Tevye L 9/20/2022 11:01 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 25, 2022 5:00 PM
9/13/2022 2:51 PM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Jackson Pond Lots 3,6,8,9,10,14-16,18-20, 22, 24-26, 28, 30-32 & 34
Lot Numbers
(If listed on the eNOI)
3,6,8, 9,10,14,15,16,18,19,20,22,24,25,26,28, 30,31,32, 34
NC Reference No.*
NCG01-2022-3230
Certificate of
NCC223230
Coverage (COC) No.*
Invoice Date
9/13/2022
Initial Invoice No.
NCC223230-2022
Initial Fee
$ 100.00
Invoice Due Date
10/13/2022
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
9/20/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
2796
NOI Tracking No.
105002
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-JOHNS-2022-Jackson Pond Lots 3,6,8,9,10,14-16,18-20, 22, 24-26, 28, 30-32
& 34