NCC223859_NOI 113219 Payment Verification_20221121

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/16/2022 12:47:43 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/16/2022 1:34:35 PM (Review - NOI 113219 Dorcurt Hills Lot 1)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/16/2022 12:48 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 21, 2022 5:00
PM 11/16/2022 12:48 PM
by Workflow 11/16/2022 1:34:42 PM (Workflow Start Event)
Submit by Holloman, Tevye L 11/21/2022 7:50:22 AM (Payment Verification for NCC223859)
F Alexander Ross
Holloman, Tevye L assigned the task to Holloman, Tevye L 11/21/2022 7:49 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 28, 2022 5:00
PM 11/16/2022 1:34 PM

5 A7
Payment Verification
NORTH CAROLINA
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Project Name
Dorcurt Hills Lot 1
Lot Numbers
(If listed on the eNOI)
Lot 1
NC Reference No.*
NCG01-2022-3859
Certificate of
NCC223859
Coverage (COC) No.*
Invoice Date
11/16/2022
Initial Invoice No.
NCC223859-2022
Initial Fee
$ 100.00
Invoice Due Date
12/16/2022
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
11/21/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
663173863
Transaction Number*
NOI Tracking No.
113219
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-CHATH-2022-Dorcurt Hills Lot 1