NCC232560_NOI 156080 Payment Verification_20230824

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 8/23/2023 10:01:34 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 8/23/2023 10:07:47 AM (Review-NOI 156080 Lot 4 475 Old Home Place)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:August 28,2023 5:00
PM 8/23/2023 10:01:41 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 8/23/2023 10:01:41 AM
Submit by Tev.Holloman 8/24/2023 10:52:31 AM(Payment Verification for NCC232560)
0 Ashley Shifflett
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:October 4,2023 5:00 PM
8/23/2023 10:08:02 AM
• Tev.Holloman assigned the task to Tev.Holloman 8/24/2023 10:52:00 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Lot 4 475 Old Home Place
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
CONFIRMED ARPA Project Number(if applicable)
Lot Numbers (If listed on the eNOI)
4
NC Reference No.* NCG01-2023-2560
Certificate of NCC232560
Coverage(COC)No.*
Invoice Date 8/23/2023
Initial Invoice No. NCC232560-2023
Initial Fee $ 100.00
Invoice Due Date 9/22/2023
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 8/24/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 706648894
Transaction Number*
NOI Tracking No. 156080
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CHATH-2023-1-ot 4 475 Old Home Place

I I