NCC241228_Annual Fee Payment Record (2025 Fee)_20250403

Action History(UTC-05:00)
by Workflow 3/29/2025 3:50:56 PM(Workflow Start Event)
Submit by Tev.Holloman 4/3/2025 1:27:54 PM(2025 Annual Fee Payment Verification for NCC241228-2025)
0 Vivian E Dickinson
• The task was assigned to DEMLR NCG01 Annual Fee Team.The due date is: May 12,2025 5:00 PM
3/29/2025 3:50:57 PM
• Tev.Holloman assigned the task to Tev.Holloman 4/3/2025 1:27:15 PM

2025 Annual Fee Payment Verification
NORTH CAROLINA
Environmental Quality
Certificate of NCC241228
Coverage(COC)No.* This is passed from the workflow when the invoice is filed.
NC Reference COC NCG01-2024-1228
No.*
Permit Status: Active
Expiration Date 3/31/2029
Year COC Issued 2024
This field will be hidden.
Check previous years for outstanding fees(years that do not apply will be blank):
2020 Fee Status 2021 Fee Status 2022 Fee Status
2023 Fee Status 2024 Fee Status
Project Name* Pine Ridge Subdivision-Phase 2
Project Address* "0"Mountain Ridge Road, Rural Hall, NC
Permittee* L R Pine Ridge Associates II, LLC
County Forsyth
Invoice No.* NCC241228-2025
This is passed from the workflow when the invoice is filed.
Annual Fee* $ 120.00
Invoice Date* 4/1/2025
This is passed from the workflow when the invoice is filed.
Invoice Due Date* 5/1/2025
This is passed from the workflow when the invoice is filed.
An automated email reminder is sent to the permittee when the invoice is due.Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Important: If you change the choice below to Payment NOT RECEIVED,the fee status becomes PAST DUE,and the
permittee will receive a Notice of Deficiency.
Annual Fee Payment Fee Payment Received or Not Applicable.
Received* Fee Payment NOT RECEIVED.
Date Payment 4/3/2025
Received* Or,if WAIVED or NOT RECEIVED,this is the date that status is recorded.

Method of Payment* electronic
check
other
ePayment 798832920
Transaction Number*
Fee Status* PAID
Legally Responsible V. Earl Dickinson, III
Person(Orig.)
Permittee E-mail* [e-mail]
CONFIRM Permittee [e-mail]
E-mail* Opportunity to modify problem e-mail address or permittee contact info
Site Contact E-mail* den ise [e-mail]
CONFIRM Site [e-mail]
Contact E-mail* Opportunity to correct problem e-mail address or site contact info
Billing E-mail [e-mail]
(If available)
CONFIRM Billing E- [e-mail]
mail Opportunity to correct problem e-mail address or billing contact info
Billing Telephone No. [phone]
Permittee Email for [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow).
Site Contact Email for [e-mail]
30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow)
Billing Contact Email [e-mail]
for 30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow).
Project Name for 30- Pine Ridge Subdivision-Phase 2
day Reminder The project name is passed from workflow for the 30-day reminder
Permittee Name for L R Pine Ridge Associates II, LLC
30-day Reminder The permittee is passed from workflow for the 30-day reminder
County for 30-day Forsyth
Reminder The county is passed from workflow for the 30-day reminder
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date* 4/3/2025