NCC231971_NOI 146952 Payment Verification_20230628

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/27/2023 8:37:56 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 6/27/2023 8:49:32 AM (Review-NOI 146952 Olde Farm-Lot 2)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:June 30,2023 5:00 PM
6/27/2023 8:38:04 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 6/27/2023 8:38:04 AM
Submit by Tev.Holloman 6/28/2023 10:17:21 AM(Payment Verification for NCC231971)
•Richard E Sherman
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:August 8,2023 5:00 PM
6/27/2023 8:49:48 AM
• Tev.Holloman assigned the task to Tev.Holloman 6/28/2023 10:16:38 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Olde Farm-Lot 2
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)
Olde Farm-Lot 2
NC Reference No.* NCG01-2023-1971
Certificate of NCC231971
Coverage(COC)No.*
Invoice Date 6/27/2023
Initial Invoice No. NCC231971-2023
Initial Fee $ 100.00
Invoice Due Date 7/27/2023
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 6/28/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 697564960
Transaction Number*
NOI Tracking No. 146952
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CHATH-2023-Olde Farm-Lot 2

I I