NCC232759_NOI 159315 Payment Verification_20231004

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 9/12/2023 11:17:59 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 9/13/2023 5:31:37 AM (Review-NOI 159315 Gates Farm-Lots 5,6, 10,21,25,28,
33&46)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: September 15,2023 5:00
PM 9/12/2023 11:18:07 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 9/12/2023 11:18:07 AM
Submit by Tev.Holloman 10/4/2023 11:22:12 AM (Payment Verification for NCC232759)
0 Daniel Furr
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:October 25,2023 5:00 PM
9/13/2023 5:31:52 AM
• Tev.Holloman assigned the task to Tev.Holloman 10/4/2023 11:21:39 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Gates Farm-Lots 5,6, 10,21,25,28,33&46
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)
Lots 5,6, 10,21,25,28,33&46
NC Reference No.* NCG01-2023-2759
Certificate of NCC232759
Coverage(COC)No.*
Invoice Date 9/13/2023
Initial Invoice No. NCC232759-2023
Initial Fee $ 100.00
Invoice Due Date 10/13/2023
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 10/4/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 712896143
Transaction Number*
NOI Tracking No. 159315
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-HOKE-2023-Gates Farm-Lots 5,6, 10,21,25,28,33&46

I I