NCC223611_NOI 109659 Payment Verification_20221024

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/19/2022 11:22:30 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/20/2022 6:46:19 AM (Review - NOI 109659 Discount Tire - Concord, NC - NCC
46)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/19/2022 11:23 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 24, 2022 5:00
PM 10/19/2022 11:23 AM
by Workflow 10/20/2022 6:46:28 AM (Workflow Start Event)
Submit by Holloman, Tevye L 10/24/2022 11:52:28 AM (Payment Verification for NCC223611)
F Halle Properties, L.L.C.
• Holloman, Tevye L assigned the task to Holloman, Tevye L 10/24/2022 11:51 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 1, 2022 5:00 PM
10/20/2022 6:46 AM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Discount Tire - Concord, NC - NCC 46
Lot Numbers
(If listed on the eNOI)
Lot 1
NC Reference No.*
NCG01-2022-3611
Certificate of
NCC223611
Coverage (COC) No.*
Invoice Date
10/20/2022
Initial Invoice No.
NCC223611-2022
Initial Fee
$ 100.00
Invoice Due Date
11/19/2022
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
10/24/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
2000104797
NOI Tracking No.
109659
Tracking ID referenced upon submittal
This is an Express
• No
Review Project
Yes
Project Tracking ID
NCC-CABAR-2022-Discount Tire - Concord, NC - NCC 46