NCC241109_NOI 191767 Payment Verification_20240411

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 4/10/2024 4:20:44 PM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 4/11/2024 6:59:20 AM (Review-NOI 191767 Dollar General-Dallas Store#30459)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:April 15,2024 5:00 PM
4/10/2024 4:21:46 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 4/10/2024 4:21:46 PM
Submit by Tev.Holloman 4/11/2024 12:17:29 PM (Payment Verification for NCC241109)
•Jennifer Edwards
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: May 23,2024 5:00 PM
4/11/2024 6:59:34 AM
• Tev.Holloman assigned the task to Tev.Holloman 4/11/2024 12:14:43 PM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Dollar General-Dallas Store#30459
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)
NC Reference No.*
NCG01-2024-1109
Certificate of Coverage(COC)No.* Permit Version
NCC241109 1.00
Invoice Date 4/11/2024
Initial Invoice No. NCC241109-2024
Initial Fee $ 120.00
Invoice Due Date 5/11/2024
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 4/11/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 742582929
Transaction Number*
NOI Tracking No. 191767
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-GASTO-2024-Dollar General-Dallas Store#30459

i i