NCC223730_NOI 111537 Payment Verification_20221109

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/1/2022 10:19:10 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/1/2022 1:55:13 PM (Review - NOI 111537 Meadow Glen)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/1/2022 10:21 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 4, 2022 5:00
PM 11/1/2022 10:21 AM
by Workflow 11/1/2022 1:55:29 PM (Workflow Start Event)
Submit by Holloman, Tevye L 11/9/2022 7:34:28 AM (Payment Verification for NCC223730)
P Bysna Investment 1, LLC
Holloman, Tevye L assigned the task to Holloman, Tevye L 11/9/2022 7:33 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 13, 2022 5:00
PM 11/1/2022 1:55 PM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Meadow Glen
Lot Numbers
(If listed on the eNOI)
5, 109, 117, 121, 122, 123, 124, 144
NC Reference No.*
NCG01-2022-3730
Certificate of
NCC223730
Coverage (COC) No.*
Invoice Date
11/1/2022
Initial Invoice No.
NCC223730-2022
Initial Fee
$ 100.00
Invoice Due Date
12/1/2022
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
11/9/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
1005
NOI Tracking No.
111537
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-IREDE-2022-Meadow Glen