NCC233317_NOI 167723 Payment Verification_20231107

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 11/6/2023 1:15:48 PM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 11/7/2023 6:45:17 AM (Review-NOI 167723 Cotton Custom Homes-Laurel Ridge
Lot 8)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: November 9,2023 5:00
PM 11/6/2023 1:15:57 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 11/6/2023 1:15:57 PM
Submit by Tev.Holloman 11/7/2023 11:48:57 AM (Payment Verification for NCC233317)
•Gina Jiampetti
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: December 19,2023 5:00
PM 11/7/2023 6:45:32 AM
• Tev.Holloman assigned the task to Tev.Holloman 11/7/2023 11:48:25 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Cotton Custom Homes-Laurel Ridge Lot 8
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)
Lot 8
NC Reference No.* NCG01-2023-3317
Certificate of NCC233317
Coverage(COC)No.*
Invoice Date 11/7/2023
Initial Invoice No. NCC233317-2023
Initial Fee $ 120.00
Invoice Due Date 12/7/2023
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 11/7/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 718254862
Transaction Number*
NOI Tracking No. 167723
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CHATH-2023-Cotton Custom Homes-Laurel Ridge Lot 8

I I