NCC233553_NOI 171909 Payment Verification_20231201

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 11/30/2023 11:33:07 AM(NCG01 NOI Submission)
Approve by Brooklyn.Broussard 12/1/2023 6:49:08 AM (Review-NOI 171909 Perkins South-Lots 1-5)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: December 5,2023 5:00
PM 11/30/2023 11:33:18 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 11/30/2023 11:33:18 AM
Submit by Tev.Holloman 12/1/2023 1:17:30 PM (Payment Verification for NCC233553)
•Leslie Groves
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:January 12,2024 5:00 PM
12/1/2023 6:49:23 AM
• Tev.Holloman assigned the task to Tev.Holloman 12/1/2023 1:17:06 PM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Perkins South-Lots 1-5
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)
Lots 1-5
NC Reference No.* NCG01-2023-3553
Certificate of NCC233553
Coverage(COC)No.*
Invoice Date 12/1/2023
Initial Invoice No. NCC233553-2023
Initial Fee $ 120.00
Invoice Due Date 12/31/2023
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 12/1/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 721739076
Transaction Number*
NOI Tracking No. 171909
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-LEE-2023-Perkins South-Lots 1-5

I I