NCC231784_NOI 144929 Payment Verification_20230609

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/7/2023 5:11:34 PM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 6/8/2023 7:45:33 AM(Review-NOI 144929 Lot 576 Brookberry)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:June 12,2023 5:00 PM
6/7/2023 5:11:42 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 6/7/2023 5:11:42 PM
Submit by Tev.Holloman 6/9/2023 10:47:52 AM (Payment Verification for NCC231784)
0 LESLIE MITCHELL
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:July 20,2023 5:00 PM
6/8/2023 7:45:50 AM
• Tev.Holloman assigned the task to Tev.Holloman 6/9/2023 10:47:18 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Lot 576 Brookberry
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
CONFIRMED ARPA Project Number(if applicable)
Lot Numbers (If listed on the eNOI)
576
NC Reference No.* NCG01-2023-1784
Certificate of NCC231784
Coverage(COC)No.*
Invoice Date 6/8/2023
Initial Invoice No. NCC231784-2023
Initial Fee $ 100.00
Invoice Due Date 7/8/2023
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 6/9/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 694837211
Transaction Number*
NOI Tracking No. 144929
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-FORSY-2023-Lot 576 Brookberry

I I