NCC233400_NOI 169523 Payment Verification_20231115

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 11/14/2023 9:37:44 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 11/14/2023 9:43:39 AM (Review-NOI 169523 Summerhouse-Windsor Homes
Lots)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: November 17,2023 5:00
PM 11/14/2023 9:37:59 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 11/14/2023 9:37:59 AM
Submit by Tev.Holloman 11/15/2023 9:53:01 AM (Payment Verification for NCC233400)
0 Sara Golser
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: December 26,2023 5:00
PM 11/14/2023 9:43:54 AM
• Tev.Holloman assigned the task to Tev.Holloman 11/15/2023 9:48:56 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Summerhouse-Windsor Homes Lots
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)
541 &631
NC Reference No.* NCG01-2023-3400
Certificate of NCC233400
Coverage(COC)No.*
Invoice Date 11/14/2023
Initial Invoice No. NCC233400-2023
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 11/15/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 719291331
Transaction Number*
NOI Tracking No. 169523
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-ONSLO-2023-Summerhouse-Windsor Homes Lots

I I