NCC242662_NOI 214496 Payment Verification_20240905

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 8/27/2024 3:48:01 PM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 8/28/2024 7:51:36 AM (Review-NOI 214496 Project JK-88)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:August 30,2024 5:00
PM 8/27/2024 3:48:32 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 8/27/2024 3:48:32 PM
Submit by Tev.Holloman 9/5/2024 4:25:40 PM(Payment Verification for NCC242662)
•H&M Company, Inc
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:October 9,2024 5:00 PM
8/28/2024 7:51:51 AM
• Tev.Holloman assigned the task to Tev.Holloman 9/5/2024 4:23:18 PM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Project JK-88
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.*
NCG01-2024-2662
Certificate of Coverage(COC)No.* Permit Version
NCC242662 1.00
Invoice Date 8/28/2024
Initial Invoice No. NCC242662-2024
Initial Fee $ 120.00
Invoice Due Date 9/27/2024
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 9/5/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
Check Number* 255005
NOI Tracking No. 214496
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-RANDO-2024-Project JK-88

i i