NCC233399_NOI 169519 Payment Verification_20231114

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 11/14/2023 9:16:20 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 11/14/2023 9:21:32 AM(Review-NOI 169519 Chapel Ridge Lot 590)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: November 17,2023 5:00
PM 11/14/2023 9:16:34 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 11/14/2023 9:16:34 AM
Submit by Tev.Holloman 11/14/2023 11:17:50 AM(Payment Verification for NCC233399)
•Thomas D Quackenbush
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: December 26,2023 5:00
PM 11/14/2023 9:21:47 AM
• Tev.Holloman assigned the task to Tev.Holloman 11/14/2023 11:17:19 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Chapel Ridge Lot 590
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)
590
NC Reference No.* NCG01-2023-3399
Certificate of NCC233399
Coverage(COC)No.*
Invoice Date 11/14/2023
Initial Invoice No. NCC233399-2023
Initial Fee $ 120.00
Invoice Due Date 12/14/2023
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 11/14/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 719288328
Transaction Number*
NOI Tracking No. 169519
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CHATH-2023-Chapel Ridge Lot 590

I I