NCC222540_NOI 97191 Payment Verification_20220715

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/13/2022 11:07:45 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 7/14/2022 7:20:24 AM (Review - NOI 97191 North Farm)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 7/13/2022 11:08 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: July 18, 2022 5:00 PM
7/13/2022 11:08 AM
by Workflow 7/14/2022 7:20:30 AM (Workflow Start Event)
Submit by Tran, Kieu M 7/15/2022 8:47:52 AM (Payment Verification for NCC222540)
F Solomon Home Builders
• Tran, Kieu M assigned the task to Tran, Kieu M 7/15/2022 8:47 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: August 25, 2022 5:00 PM
7/14/2022 7:20 AM

5 A7
Payment Verification
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
North Farm
Lot Numbers
(If listed on the eNOI)
1-5
NC Reference No.*
NCG01-2022-2540
Certificate of
NCC222540
Coverage (COC) No.*
Invoice Date
7/14/2022
Initial Invoice No.
NCC222540-2022
Initial Fee
$ 100.00
Invoice Due Date
8/13/2022
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
7/15/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
643178733
Transaction Number*
NOI Tracking No.
97191
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-HARNE-2022-North Farm