NCG180036_Returned Invoice_20190820

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY
INVOICE
Annual Permit Fee
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This annual fee is required by the North Carolina Administrative Code. It covers the administrative costs associated with
your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's
operating status. Failure to pay the fee by the due date will subject the permit to revocation. Operating without a valid
permit is a violation and is subject to a $10,000 per day fine. If the permit is revoked and you later decide a permit is
needed, you must reapply, with the understanding the permit request may be denied due to changes in environmental,
regulatory, or modeling conditions.
Invoice Number: 2019PR007173 q0C;zV
nnual Fee Period: 2019-09-01 to 2020-08-31
Permit Number: NCG180036 Invoice Date: 08/08/2019
Guilford County
Haworth Inc -Wood Seating Plant 6 r V Due Date: 09/07i2019
William Stoddard Annual Fee: $100.00
Haworth Inc ti ff - -� 2f1 4 1. 0 0 Z 8 3- 4 j 1
PO Box 2490
High Point, NC 27261 RETURN TO SENDER
9 NCT DEI IVERABLE AS ADDRESSED
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Payment Options: SC: r 7 6 9 91 C 12 9 9 '" 114 = 1, 9 r- 0 9 - 3 Via;
1. Electronic payment convenient and quick. To sj 1t`It`='Eijil'y':iit �ia.iie�laa a s#xo s's+aia + irx,
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browser. If you select eCheck, there will be no cot
convenience fee for a debit card is $3.95. You will receive a receipt immediately after payment via email.
2. To pay by mail, please make your check payable to "DEMLR Stormwater Program" and include the invoice number on the check.
Then, detach the invoice below and write the check number on the invoice. A $25.00 processing fee will be charged
for returned checks in accordance with N.C. General Statute 25-3-512.
Remit payments by mail to:
NCDEQ - Division of Energy, Mineral and Land Resources
Attn: Stormwater Billing
512 N. Salisbury Street
1612 Mail Service Center
Raleigh, NC 27699-1612
3. Non-payment of this fee by the payment due date will initiate the permit revocation process.
4. Please include your permit number in all correspondence.
5. Should you have any questions, please contact the Fee Coordinator at [phone].
(Return This Portion With Check)
ANNUAL PERMIT INVOICE
Invoice Number:
Permit Number:
William Stoddard
Haworth Inc
PO Box 2490
High Point, NC 27261
2019PR007173
NCG180036
Guilford County
Haworth Inc -Wood Seating Plant
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Open
Annual Fee Period: 2019-09-01 to 2020-08-31
Invoice Date: 8/8/2019
Due Date: 9/7/2019
Annual Fee: $100.00
Check Number: