NCC224086_NOI 118066 Payment Verification_20221214

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/9/2022 11:28:07 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 12/12/2022 6:35:11 AM (Review - NOI 118066 Senters Assisted Living)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 12/9/2022 11:28 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 14, 2022 5:00
PM 12/9/2022 11:28 AM
by Workflow 12/12/2022 6:35:24 AM (Workflow Start Event)
Submit by Holloman, Tevye L 12/14/2022 2:52:02 PM (Payment Verification for NCC224086)
F Carolina Commercial Contractors LLC
Holloman, Tevye L assigned the task to Holloman, Tevye L 12/14/2022 2:51 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 23, 2023 5:00 PM
12/12/2022 6:35 AM

Payment •
NORTH CAROLINA
Environmental Quallty
Project Name
Senters Assisted Living
Lot Numbers
(If listed on the eNOl)
NC Reference No.*
NCG01-2022-4086
Certificate of
NCC224086
Coverage (COC) No.*
Invoice Date
12/12/2022
Initial Invoice No.
NCC224086-2022
Initial Fee
$ 100.00
Invoice Due Date
1/11/2023
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
12/14/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
12569
NOI Tracking No.
118066
Tracking ID referenced upon submittal
This is an Express
No
Review Project
Yes
Project Tracking ID
NCC-LEE-2023-Senters Assisted Living