NCC240203_NOI 178606 Payment Verification_20240123

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 1/22/2024 10:10:27 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 1/22/2024 10:16:25 AM (Review-NOI 178606 Bluestone Subdivision)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:January 25,2024 5:00
PM 1/22/2024 10:10:35 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 1/22/2024 10:10:35 AM
Submit by Tev.Holloman 1/23/2024 9:35:50 AM (Payment Verification for NCC240203)
0 Chloe Plaut
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: March 4,2024 5:00 PM
1/22/2024 10:16:40 AM
• Tev.Holloman assigned the task to Tev.Holloman 1/23/2024 9:34:44 AM

a STA7[
W
Payment Verification
I, i1
�1.
NORTH CAROLINA
Environmental Quality
Project Name Bluestone Subdivision
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 18
NC Reference No.* NCG01-2024-0203
Certificate of NCC240203
Coverage(COC)No.*
Invoice Date 1/22/2024
Initial Invoice No. NCC240203-2024
Initial Fee $ 120.00
Invoice Due Date 2/21/2024
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 1/23/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 729764104
Transaction Number*
NOI Tracking No. 178606
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-FORSY-2024-Bluestone Subdivision

I I