NCC233685_NOI 173527 Payment Verification_20240103

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 12/13/2023 9:33:11 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 12/13/2023 9:56:01 AM (Review-NOI 173527 Practice Facility Renovation)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: December 18,2023 5:00
PM 12/13/2023 9:33:18 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 12/13/2023 9:33:18 AM
Submit by Tev.Holloman 1/3/2024 1:54:15 PM(Payment Verification for NCC233685)
0 Dave Mongon
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:January 24,2024 5:00 PM
12/13/2023 9:56:17 AM
• Tev.Holloman assigned the task to Tev.Holloman 1/3/2024 1:53:57 PM

Payment Verification
NORTH CAROLINA
Environmental Quality
Project Name Practice Facility Renovation
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 eNOl)
NC Reference No.* NCG01-2023-3685
Certificate of NCC233685
Coverage(COC)No.*
Invoice Date 12/13/2023
Initial Invoice No. NCC233685-2023
Initial Fee $ 120.00
Invoice Due Date 1/12/2024
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 1/3/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 726491711
Transaction Number*
NOI Tracking No. 173527
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-MECKL-2024-Practice Facility Renovation