NCC223399_NOI 106751 Payment Verification_20220929

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/28/2022 9:55:12 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 9/28/2022 10:06:00 AM (Review - NOI 106751 Fairfield Farm, Section Six, Part
Two)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/28/2022 9:55 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 3, 2022 5:00 PM
9/28/2022 9:55 AM
by Workflow 9/28/2022 10:06:17 AM (Workflow Start Event)
Submit by Holloman, Tevye L 9/29/2022 7:54:51 AM (Payment Verification for NCC223399)
F HS Floyd
• Holloman, Tevye L assigned the task to Holloman, Tevye L 9/29/2022 7:54 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 9, 2022 5:00 PM
9/28/2022 10:06 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Fairfield Farm, Section Six, Part Two
Lot Numbers (If listed on the eNOI)
Lots 53-58, 63-65 & 67
NC Reference No.* NCG01-2022-3399
Certificate of NCC223399
Coverage (COC) No.*
Invoice Date 9/28/2022
Initial Invoice No. NCC223399-2022
Initial Fee $ 100.00
Invoice Due Date 10/28/2022
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 9/29/2022
Received * (Or, if not received, date rejected for no payment)
Method of Payment* • electronic
check
Other
ePayment 655164964
Transaction Number*
NOI Tracking No. 106751
Tracking ID referenced upon submittal
This is an Express • No
Review Project Yes
Project Tracking ID NCC-CUMBE-2022-Fairfield Farm, Section Six, Part Two