NCC201171_Annual Fee Payment Record (2023 Fee)_20230322

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 2/28/2023 8:16:54 PM (Workflow Start Event)
Submit by Paul.Clark 3/22/2023 10:36:48 PM (2023 Annual Fee Payment Verification for NCC201171-2023)
• The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: April 11, 2023 5:00 PM
2/28/2023 8:16:54 PM
• Paul.Clark assigned the task to Paul.Clark 3/22/2023 10:36:15 PM

a STA7[
NORTH CAROLINA
Environmental Quality
Certificate of
NCC201171
Coverage (COC) No.*
This is passed from the workflow when the invoice is filed.
NC Reference COC
NCG01-2020-1171
No. *
Permit Status:
INACTIVE
Already Rescinded:
3/22/2023
This field appears if the permit has already been terminated.
Year COC Issued
2020
This field will be hidden.
Check previous years for outstanding fees (years that do not apply will be blank):
2020 Fee Status
2021 Fee Status 2022 Fee Status
PAID PAID
WAIVE FEE?*
Yes, Payment Not Applicable
No, Payment Still Applies
Project Name*
Brooke Ridge
Project Address*
Fisher Ferry Road, Thomasville, NC
Permittee*
Blair Appraisal Service, Inc.
County
Davidson
Invoice No.*
NCC201171-2023
This is passed from the workflow when the invoice is filed.
Annual Fee*
$ 100.00
Invoice Date*
3/1/2023
This is passed from the workflow when the invoice is filed.
Invoice Due Date*
4/1/2023
This is passed from the workflow when the invoice is filed.
An automated email reminder
is sent to the permittee when the invoice is due. Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Important: If you change the choice below to Payment NOT RECEIVED, the fee status becomes PAST DUE, and the
permittee will receive a Notice of Deficiency.
Annual Fee Payment Fee Payment Received or Not Applicable.
Received* Fee Payment NOT RECEIVED.
Date Payment 3/22/2023
Received * Or, if WAIVED or NOT RECEIVED, this is the date that status is recorded.

ePayment
Transaction Number*
Check Number*
Fee Status* WAIVED
Legally Responsible Brent Blair
Person (Orig.)
Permittee E-mail* [e-mail]
CONFIRM Permittee [e-mail]
E-mail * Opportunity to modify problem e-mail address or permittee contact info
Site Contact E-mail* [e-mail]
CONFIRM Site
[e-mail]
Contact E-mail*
Opportunity to correct problem e-mail address or site contact info
Billing E-mail
(If available)
CONFIRM Billing E-
Opportunity to correct problem e-mail address or billing contact info
mail
Billing Telephone No.
Permittee Email for [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed (passed from workflow).
Site Contact Email for [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed (passed from workflow)
Billing Contact Email This is the email for the 30-day reminder if needed (passed from workflow).
for 30-day Reminder
Project Name for 30- Brooke Ridge
day Reminder The project name is passed from workflow for the 30-day reminder
Permittee Name for Blair Appraisal Service, Inc.
30-day Reminder The permittee is passed from workflow for the 30-day reminder
County for 30-day Davidson
Reminder The county is passed from workflow for the 30-day reminder
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date* 3/22/2023