Loading...
266 Boger Rd (2)Davie Countv, NC Tax Parcel Reuort Fridav, October 7, 201 E WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: E60000001904 Township: Farmington NCPIN Number: 5851637022 Municipality: Account Number: 8305225 Census Tract: 37059-802 Listed Owner 1: ALLEGACY FEDERAL CREDIT UNION Voting Precinct: SMITH GROVE Mailing Address 1: PO BOX 26043 Planning Jurisdiction: Davie County City: WINSTON SALEM Zoning Class: DAVIE COUNTY R -20,1-4-S State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27114-6043 Voluntary Ag. District: No Legal Description: 7.572 AC OFF US HWY 158 Fire Response District: SMITH GROVE Assessed Acreage: 7.56 Elementary School Zone: PINEBROOK Deed Date: 7/2015 Middle School Zone: NORTH DAVIE Deed Book / Page: 009940184 Soil Types: EnC,MsC,MsB Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 78990.00 Outbuilding & Extra 8460.00 Freatures Value: Land Value: 57850.00 Total Market Value: 145300.00 Total Assessed Value: 145300.00 l v� 9 1fl16 Davie County, All data Is provided as is without warranty or guarantee of any kind either expressed or Implied including but not limited to the Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS webslte shall hold harmless the NC County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or Inability to use the GIS data provided by this website. Davie County Environmental Health v P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780/Fax(336)753-1680 WELL PERMIT Account #: 990005436 Billed To: Jane Willis Reference Nance: Proposed Facility: Residential -Well Tax PIWEH #: 5851 -63 -7022 -Well Subdivision Into: LocationiAddress: Hwy 158-27028 toperty ize: ,. 7.57 Acres ATC Number: 0063 Actions of the employees of the Davie County EH Section shall in no way be taken as a guarantee that this well will produce water of any particular quantity or quality or for any amount of time. This permit is valid for a period of 5 years from the date of issuance. This permit may be revoked if it is determined that there has been a material change in any fact/circumstances upon which this permit was issued. Permit Type: New 9— Repair ❑ Abandonment ❑ I W.P. 7-08 Proposed 1 Location Diagram Certificate of Completion Diagram l Cmments: ' Driller: &&/,t.) VZU,11 Certification #: Grout Inspected: — /122,910 1, Well Head Inspected: GPS Coordinates: EHS: QQ 350 ye, 41T6 A) g(7o� 4 Date: EHS:Q�(�l ate: �Q AxCUrA� t)4 I W.P. 7-08 wee \ PPLICATION FOR PRIVATE WELL PERMIT Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax (336)753-1680 ***IMPORTANT*** CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. APPLICANT INFORMATION Name J Contact Person Address HW"Phone City/State/ZIP pal D Business Phone Name on Permit if Differen than Above Mailing Address /�,px a1� City/State/Zip c,_„ yr Q PROPERTY INFORMATION *Date House/Facility Corners Flagged /VO U) NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat (to scale) Owner's NameZ7a4,� W �� ;S ` � Ne 3n of Phone Number _ 9Vl i—/ 7 / 7 Owner's Address City/State/Zip Property Address o _ v City P 6 C_ ((_C_'1 , C Lot Size___7t S Tax PIN# Subdivision Name(if applicable) SecItion/Lot# Directions To Site: / S'g an ' n r _ Qrf �lurz� On -ta -7 oa e u — DEVELOPMENT INFORMATION Permit Type: New Well � Well Repair Well Abandonment Other (specify) Facility Type: Residential ►/ Food Service Church Commercial Other Are There Any Septic Systems Currently On The Site? YES NO Do You Intend To Install A New Septic System On This Site? YES 1/ NO TERMS AND CONDITIONS: This application must be accompanied by a plat or site plan of the property that includes the existing and proposed property lines with dimensions, the specific location of the facility and any existing or future appurtenances, the location of any existing septic system, sewer lines, water lines, any existing water supplies and any surface waters. The applicant is responsible for identifying and marking the property lines and comers. The applicant is responsible for making the site accessible. By signing this application, the applicant signifies that they understand the terms and conditions and that they give permission for Davie County Environmental Health representatives to perform necessary field evaluations and procedures deemed necessary to determine the best location for a well. ��MA I n�;& Signed (j 7/30/09 9/�o/�v Dat Site Revisit Charge Date(s): Client Notification Date: EHS: Account #J Invoice # ID 'J ". RESIDENTIAL WELL CONSTRUCTION RECORD �0; North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # –�03 ' RECEIVED NOV 0 2 2W 1. WELL CONTRACTOR: l /Lt Tr4Lty .L Well Contractor (Individual) Name YADKIN WELL COMPANY. INC. Well Contractor Company Name 1908 HAMPTONVILLE ROAD Street Address HAMPTONVILLE NC 27020 City or Town State Zip Code 336 ) 468-4440 Area code Phone number g. WATER' ZONES (depth): th): 00NiYHEAapi.)L- � PPotEi< 1 Top —�3 • Bottom A on. Top / 3 $' Bottom L 3 R' Top Bottom Top Bottom Top Bottom Thickness/ 7. CASING: Depth Diameter Weight Material Top Bottom 6s Ft.61/2-r f SIM -1/ 10VG Top Bottom Ft. Top Bottom Ft. 8. GROUT: Depth Material 2. WELL INFORMATION: / /�Top�_ Bottom .c r Ft. Le4t�-`/t- WELL CONSTRUCTION PERMIT'' 5 F Sf - 4 3 -2D� 2 l.✓ c!`7 Top Bottom Ft. OTHER ASSOCIATED PERMIT#(if pplica le Top Bottom Ft. SITE WELL ID #(if applicable) 9. SCREEN: Depth Diameter Slot Size Method Material 3. WELL USE (Check Applicable Box): Residential Water Supply E�- Top ottom Ft. in, in. DATE DRILLED �� - // - /Ci / ` Top Ft. in, in. Top/ Bottom'' Ft. in. in. TIME COMPLETED , qS AM ❑ PM 4. WELL LOCATION: CITY: ��v��6 le COUNTY f (Street Name, Numbers, CgnJ unity, Subdivision-. Lot No., Parcel, Zip Code) TOPOGRAPHIC / LAND SETTING: (check appropriate box) P6lope ❑Valley ❑Flat ❑Ridge []Other /LATITUDE `,' " DMS OR 3S ? 74gaD LONGITUDE • " DMS ORP' Y DO Latitude/longitude source: RSPS i 1-opographic map (location of well must be slf own on a USGS topo map andattached to this form if not using GPS) 5. WELL OWNER / A4ye; n Lei _ g 6QCl Owner game Street Address 4Pel e'F- c,, ;0L A, S- .2 %0 �)- 3 City or Town State Zip Code Area c de Phone number G. WELL DETAILS: a. TOTAL DEPTH:_ 10. SANDIGRAVEL PACK: epth Size Topottom Ft. Top Bottom Ft. Top Bottom Ft. 11. DRILLING LOG Top Bottom, gop�z^— - U—/ x -el Sal �l� Material Formation Description �f Ale.' i��p�i�#L 12. REMARKS: -/,;L ' :"/ 3-1 6 O - 30jp.n Jou lzzd eei.(' l' x _ eA Ad '014 b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO //l I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN c. WATER LEVEL Below Top of Casing: 36 FT. ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION (Use "+" if Above Top of Casing) STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. d. TOP OF CASING IS % FT. Above Land Surface" *Top of casing terminated at/or below land surface may require /0 - le) a variance In accordance with 15A NCAC 2C .0118. SIGNATURE OFCERTIFIED WELL CONTRACTOR DATE e. YIELD (gpm): METHOD OF TEST"r �� f�l�� �� Ja lw4,1^ L DISINFECTION: Type HTH _ Amount PRINTED NAME OF PERSON CONSTRUCTING THE WELL A06 + .D. G. N:,, S Submit Within 30 days of completion to: Division of Water Quality - Information Processing, Form GW -1a 1617 Mail Service Center, Raleigh, NC 27699-161, Phone :(919) 807-6300 Rev. 2/09 Date Site VisitedLD — �.�p By: ///j Permit: Yes No What Is Height of 60ell Casing? Make Sure 12" Above Ground III ADDRESS: PHONE NUMBER: )VA'f X- 05 10, 03:06p ■ %M Account Billed Reference Nar Proposed. Facia ATC Number Actions of t well will pr for a period has been a r Permit TVD( W.P. 7-08 Information ,Services 3367531680 p.1 Davi a County Enviranm Intal Health P.O. Box 8481210 Hospita Street Nu V �O�O Mocksville; NC 270 8 DAUIEC)ONTYHEAIfhlJf=>✓Htl�llt :(336753-67801 Fax (336)7 3-1680 EN WELL PEIZATIT I .. I 990005436 I Tax'F'IKEH M 5851 -63 -7022 -Well Jane Willis ! Subdivision°Info: Local oniAddress: Hwy 158-21028 Residential -Well P" merty-Size: 1. 1.57 Acres . i 0063 employees of the Da) ie County EH Section shall in no way be taken as a guarantee that ibis uce water of any parti ular quantity- or quality or for any amount of time. This permit is valid F5 years from the date of issuance. This permit may be revoked if it is determined that there terial change in any f tfcircumstances upon which this permit was issued. New [ Repair Abandonment ❑ )posed 1 Location Diagram; Certificate of Completion Diagram t • r i I I 1 i' I , '�4,� " Dri fler: Wit( QMC4 Certification #: i Grout Inspected: I Well Head Inspected: i GPS Coo dinates: ©1'C 0: EHS: Date: