NCC223929_NOI 113996 Payment Verification_20221206

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/21/2022 1:41:39 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/22/2022 6:57:30 AM (Review - NOI 113996 Summit Place Townhomes &
Residence Inn)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/21/2022 1:42 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 24, 2022 5:00
PM 11/21/2022 1:42 PM
by Workflow 11/22/2022 6:57:37 AM (Workflow Start Event)
Submit by Holloman, Tevye L 12/6/2022 12:20:16 PM (Payment Verification for NCC223929)
F SHG LLC
• Holloman, Tevye L assigned the task to Holloman, Tevye L 12/6/2022 12:19 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 3, 2023 5:00 PM
11/22/2022 6:57 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Summit Place Townhomes & Residence Inn
Lot Numbers
(If listed on the eNOI)
N/A
NC Reference No.*
NCG01-2022-3929
Certificate of
NCC223929
Coverage (COC) No.*
Invoice Date
11/22/2022
Initial Invoice No.
NCC223929-2022
Initial Fee
$ 100.00
Invoice Due Date
12/22/2022
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
12/6/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
1016
NOI Tracking No.
113996
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-ORANG-2023-Summit Place Townhomes & Residence Inn