NCC223690_NOI 110338 Payment Verification_20221028

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/26/2022 4:03:16 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/27/2022 8:13:28 AM (Review - NOI 110338 Dollar General (Warrenton, NC))
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/26/2022 4:03 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 31, 2022 5:00
PM 10/26/2022 4:03 PM
by Workflow 10/27/2022 8:13:37 AM (Workflow Start Event)
Submit by Holloman, Tevye L 10/28/2022 8:52:54 AM (Payment Verification for NCC223690)
F Matthew Williams
Holloman, Tevye L assigned the task to Holloman, Tevye L 10/28/2022 8:52 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 8, 2022 5:00 PM
10/27/2022 8:13 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Dollar General (Warrenton, NC)
Lot Numbers
(If listed on the eNOI)
NA
NC Reference No.*
NCG01-2022-3690
Certificate of
NCC223690
Coverage (COC) No.*
Invoice Date
10/27/2022
Initial Invoice No.
NCC223690-2022
Initial Fee
$ 100.00
Invoice Due Date
11/26/2022
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
10/28/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
659844165
Transaction Number*
NOI Tracking No.
110338
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-WARRE-2022-Dollar General (Warrenton, NC)