NCC216128_NOI 72259 Payment Verification_20211105

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/2/2021 3:12:00 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/3/2021 9:41:58 AM (Review - Construction NOI 72259)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/2/2021 3:12 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 4, 2021 5:00
PM 11/2/2021 3:12 PM
Submit by Evans, Shaundra M 11/5/2021 7:51:53 AM (Payment Verification for NCC216128)
F Richard Cotton
• Evans, Shaundra M assigned the task to Evans, Shaundra M 11/5/2021 7:51 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 15, 2021 5:00
PM 11/3/2021 9:42 AM

5 A7
Payment Verification
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Fairfield Mixed Use Buildings 3 & 4
Lot Numbers
(If listed on the eNOI)
N/A
NC Reference No.*
NCG01-2021-6128
Certificate of
NCC216128
Coverage (COC) No.*
Invoice Date
11/3/2021
Initial Invoice No.
NCC216128-2021
Initial Fee
$ 100.00
Invoice Due Date
12/3/2021
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
11/5/2021
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
601204325
Transaction Number*
NOI Tracking No.
72259
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-NEW H-2022-Fairfield Mixed Use Buildings 3 & 4