NCC230200_NOI 123606 Payment Verification_20230125

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/23/2023 9:03:37 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 1/23/2023 9:14:06 AM (Review - NOI 123606 KPG Properties, LLC Dental Office
1007 Newman Rd)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 1/23/2023 9:04 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 26, 2023 5:00
PM 1/23/2023 9:04 AM
by Workflow 1/23/2023 9:14:14 AM (Workflow Start Event)
Submit by Holloman, Tevye L 1/25/2023 1:42:15 PM (Payment Verification for NCC230200)
F William Kincaid
• Holloman, Tevye L assigned the task to Holloman, Tevye L 1/25/2023 1:41 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 6, 2023 5:00 PM
1/23/2023 9:14 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name KPG Properties, LLC Dental Office 1007 Newman Rd
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2023-0200
Certificate of NCC230200
Coverage (COC) No.*
Invoice Date 1/23/2023
Initial Invoice No. NCC230200-2023
Initial Fee $ 100.00
Invoice Due Date 2/22/2023
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 1/25/2023
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 673171631
Transaction Number*
NOI Tracking No. 123606
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CRAVE-2023-KPG Properties, LLC Dental Office 1007 Newman Rd