1691 County Line Rd (2)Davie County. NC
Tax Parcel Report Fridav, October 7, 201 E
WARNING: THIS 1S NOTA SURVEY
r
Davie County,
Parcel Information
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Parcel Number:
F100000046
Township:
Calahaln
NCPIN Number:
5800074748
Municipality:
Account Number:
70428000
Census Tract:
37059-801
Listed Owner 1:
SPRY NORMAN S
Voting Precinct:
NORTH CALAHALN
Mailing Address 1:
1691 COUNTY LINE ROAD
Planning Jurisdiction:
Davie County
City: HARMONY
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
28634-0000
Voluntary Ag. District:
No
Legal Description:
1.12 AC COUNTY LINE RD
Fire Response District:
SHEFFIELD - CALAHALN
Assessed Acreage:
1.13
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
4/1976
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
000980438
Soil Types:
PcC2,CeB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
101510.00
Outbuilding & Extra
Freatures Value:
10120.00
Land Value:
19500.00
Total Market Value:
131130.00
Total Assessed Value:
131130.00
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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 website shall hold harmless the
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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.
RECEIVED
YYi'.LL CONSTRUCTION RECORD For Internal Use ONLY:
This form can be used for single or multiple wells DC H E LT H
1 Well Contractor Information:
Well Contractor e
D
NC Well Contractor Certification Number
adkin Well Company, Inc.
Company Name
2. Well Construction Permit #: 7 Q
List all applicable well construction permits Cl.e. County, State, Pariance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (HeatinE/Cooling Supply) VResidential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
Non NVater Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge ❑Groundwater Remediation
❑Aquifer Storage and Recovery []Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal (Heatins/Cooling Return) ❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 4/ IT' q Well ID#Mz —1
Sa./Well Location: Phone number
Facility/Owner Name 7� Facility ID' (if applicable)
1( 17 It 4C6 //,I, e_ kl, A -elk (i
Physical Address, City, and Zip
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
3S Z d N Yd W
6. Is (are) the well(s): Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ,Mo
If this is a repair, fill out known well co struction information and explain the nature ofthe
repair under k21 remarks section or on the back of this form.
8. Number of wells constructed:.
For multiple h jection or non -water sipply wells ONLY with the sone construction, you can
submitoneform.
9. Total well depth below land surface: 3yd` (ft.)
For multiple wells list ail depths ifelifferent (example- 3@200' and 2@100')
10. Static water level below top of casing: (ft.)
If water level is above casing use
11. Borehole diameter: (in.) Bit Off & . Ccs-
12. Well coustruction method: _ Rotary
(i.e. auger, rotary, cable, direct push, etc.)
14. NATER ZONES
FROM TO DESCRIPTION
3�T rt. 7
ft. ft.
15. OUTER CASING for multi -used wells OIt LINER if a Gcahle
FROM TO DLAhIETER 'lIIICKN'sS MATERLAL
ft. ft. in.
16. INNER CASING OR TUBING keothermal closed -loo
FROM TO DL4AIETER THICKNESS MATERLAL
ft. 0 3 ft. �,ta,�• in. �R
ft. ft. in.
17. SCREEN
FROM TO DL41%IETER SLOT SIZE THICKNESS I MATERIAL
ft. ft. in.
ft. ft. in•
18. GROUT
FROM TO MATERL4L EMPLACEMENT METHOD & AMOUNT
ft. fa yy • 1 are(
1VI e.Y•y4
ft. a. ft. 4 t1.1 -(
ft ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERLAL EMPLACEMENT METHOD
ft ft.
ft. ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM TO DESCRIPTION color, hardness, soil/rack type, grain size, etc.
Q ft 9C2 ft.
qo ft. -ft.
ft. ft.
ft ft
ft ft.
ft. ft
ft ft.
21. REMARKS
AA, Arne -01
22. Certification:
S' .cure df ified Well Contractor Date
By signing this form, 7herSy cert, that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C.0200 If'ell Construction Standards and drat a
copy ofthis recon hos been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional paves ifnecessary.
SU13MITTALINSTUCTIONS
24a. For All Wells: Subunit this form within 30 days of completion of well
construction to the following.
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (apm) 100 Method of test: 61� 24c. For Water Suaniy & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: HTH Amount: / CUpS completion of well construction to the county health department of the county
where constructed.
Form GW -1 North Carolina Department ofEnvironment and Natural Resources —Division ofWater Quality Revised Jan. 2013
Builders Name:
Address:
Phone Number:
Owners Name:
Address:
�Ad
Phone:
Cell Number:
Well Construction Permit
Davie County Health Department
210 Hospital Street
" P.O. Box 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Property Owner: Norman Spry
Address: 11.oI doudv L 1116
City:
State/Zip: NC ij�3//
Phone 4:
For Office Use Only
'CDP File Number 137370
PIN Number: F1-000-00-046
Tax Lot #: Tax Block #:
Evaluated For: WELL
PERMIT VALID UNTIL: 4/14/2019
Applicant: Norman Spry
Address:
City:
StatelZip: NC
Phone 9:
Property Location & Site Information
Address/Road #: Subdivision:
1691 County Line Road
Harmony NC 28634
Site Address: 1691 County Line Road
Phase: Lot:
'Proposed use of Well:
Directions If Other:
Directions: Hwy 64 West right on 901, then right on
County Line Rd. Property on left after Edwards Rd.
Well Contractor Information
Drilling Contractor Driller Registration
Permit Conditions
'Permit Conditions
If
41
Well location. installation. and protection must meet all state and local regulations and must be inspected and approved by an authorized representative of
the Local Health Department, the permit may be revoked at anytime for failure to comply with existing regulations. The siting of the well by the Health
Department is to provide protection from the kno:vn possible sources of contamination. The well site may not be changed without written permission from
an authorized representative of the Local Health Department. No volume or quality of water is guaranteed by the Health Department
'Issued By: 2140 - Nations, Robert 'Date of Issue{ 0, 4,/ 1 1 1 4 1/ 1.2 1 0 1 1 1 4
Authorized State Agent:** 01 -land Drawing Olmport Drawing
Site Plan/Drawing attached.**
WELL CONSTRUCTION PERMIT
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
CDP File Number: 137370
County File Number: Fl -000-00-046
Date: 04/ 1 4 j a 0 1 4
Q Inch
APPLICATION FOR PRIVATE W PLL PERMIT
RECEIVED Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
.�•��j (336)753-6780 / Fax (336)753-1680
***IMPORTANT***
THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED.
h
APPLICANT INFORMATION
Name
Address & q /
City/State/ZIP
Name on Permit if Different than
Mailing Address
Contact Person - 71b2�rna-,✓ yup) e -c cc ,��Lu�
Home Phone
X810 �< Business Phone
City/State/Zip
PROPERTY INFORMATION *Date House/Facility Corners Flagged
NOTE: A survey plat or site plan must accompany thisplication. Included: ❑ Site Plan ❑Plat (to scale)
Owner's Name Phone Number Z . -I-
Owner's
Owner's Address G q City/State/Zip WC a 86 3
Property Address City
Lot Size /..b 7 Tax PIN#
Subdivision Name(if a plicable) Section/Lot#
Dir ecti ns T Site: d - �IZlVe, 8N
DEVELOPMENT INFORMATION
Permit Type: New Well _!/ Well Repair Well Abandonment Other (specify)
Facility Type: Residential —jam Food Service Church Commercial Other
Are There Any Septic Systems Currently On The Site? YES V' NO
Do You Intend To Install A New Septic System On This Site? YES NO r/
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 corners. 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.
Signed IV Date
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
7/30/09 Account # 7�
Invoice #
Appraisal Card
DAVIE COUNTY. NC
Page 1 of 1
4 714 7 7014 11.O7i0 AM
PRY NORMAN S SPRY LOUISE 8
Return/Appeal Notes: Parcel: F3-000-00-046
1691 COUNTY LINE RD
PLAT: / UNIQ ID 8481
70428000
D29 -P20
ID NO: 5800074748
COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of 1
Reval Year: 2013 Tax Year: 2014
1.12 AC COUNTY LINE RD
1.150 AC
SRC= Inspection
Appraised by 02 on 08/30/2007 01002 CALAHAN
TW -01
Cl- FR -14 EX- AT- LAST ACTION 20120305
CONSTRUCTION DETAIL
MARKET VALUE
DEPRECIATDN CORRELATION OFVALUE
Foundation - 3
1 Standard I
0.3400
Continuous Footing
5.0c
Eff.
Area
OUA
BASE
RATE
I RCN I EYB
I AYBREDENCE
TO MARKET
Sub Floor System - 4
USE
MO
01
01
11,8781117
81.90
153809 197
1969
% GOOD 66.0 DEPR. BUILDING VALUE - CARD
101,51
Plywood 8.0
Exterior Walls - 21
TYPE: Single Family Residential
Single Family Residential DEPR. OB/XF VALUE - CARD
10,12
Face Brick
34.0
STYLE: 5 - Ranch w/
Casement
ARKET LAND VALUE - CARD
OTAL MARKET VALUE - CARD
19,50
131,13
Roofing Structure - 03
Gable
8.0
Roofing Cover- 13
Metal Standing Seam
10.0c
TOTAL APPRAISED VALUE - GRD
TOTAL APPRAISED VALUE - PARCEL
131,13
131,13
Interior Wall Construction - 5
Drywall/Sheetrock
20.0
Interior Floor Cover - 08
Sheet Vinyl/Laminate
6.00
TOTAL PRESENT USE VALUE - PARCEL
TOTAL VALUE DEFERRED - PARCEL
Interior Floor Cover - 14
Carpet
0.0
I U
B M
I
TOTAL TAXABLE VALUE - PARCEL
PRIOR
131,13
Heating Fuel - 02
il, Wood or Coal
0.0c
I
1
I
I
BUILDING VALUE
93,43
Heating Type - 04
Fo
0C
I
2
B
I
2
g
BXF VALUE
ND VALUE
RESENT USE VALUE
11,77
18,920
Air Conditioning Type - 03
Central
4.0
I
I
I
I
DEFERRED VALUE
FOTAL VALUE
124,12
Bedrooms/Bathrooms/Half-Bathrooms
/1/1
11.00C
I
I
I
Bedrooms
BAS -3FUS -0LL-O
+-----------51------------+
Bathrooms
BAS - 1 PUS - 0 LL - 0
+--16 - - - + -
- - - - - - - - - - 5 1 - - - - - - - - - - - - +
PERMIT
CODE DATE I NOTE I NUMBER AMOUNT
Half -Bathrooms
BAS - I FUS- 0 LL- 0
7UST 7BAS
+--16-'-+
I
I
Office
I F C P I
1 1
I 1
2 2
1 1
I
I I
I I
+--16---+-8-+-------34-------+-9--+
I
I
2
8
I
I
I
I
ROUT: WTRSHD:
SALES DATA
FF. IINDICATE RECORD ATE DEED SALES
BOO PAGE O R TYPE / / PRICE
0098 438 4 197 WD X I
-01
TOTAL POINT VALUE 110.00
BUILDING ADJUSTMENTS
Quality3 AVG 1.000
ha a Desi 4 FACTOR 4 1.050iI
Size 3 Size 1.010
TOTAL ADJUSTMENT FACTOR 1.06
TOTAL QUALITY INDEX
10
I P T O
I
1
1
2
2
HEATED AREA 1,428
1
I
+---------
---- 58--------------
NOTES
SUBAREA
UNIT
ORIG %
ANN DEP % 08/XF DEPR
GS
ODE DESCRIPTION COUNT LTtjNIT
PRICE
COND LOGS "BIEY8 RATE GOND
VALUTYPE
AREA % RPL CS 1 ORAGE
9615.0c100
_
197 1980 S 1
1BAS
1,42 10 11695
3 RPORT 1
19 10.0c
0 _
00 007 S 8"'
jV
157
FCP 33 2 688
3 RPORT 4
48 10.0
_
00 007 S 8
393PTO
69 0 286
1 ORAGE 1
56 10.0
00 007 S 8
459
BM 1,42 2 2342
OTAL OB XF VALUE
10,11f
ST 11 4 368
FIREPLACE 1 - None 0
UBARESA
L4,00 153,80
OTAL.
BUILDING DIMENSIONS BAS=W5IUST=W 16S7R:P=S21 E16N21W I6$E16N7$S28E8PTO= E34S 12W8N12E24$E43J28$ PTR=N10 UBM=N28W51S28E51$ S30$
LAND INFORMATION
HIGHEST
THER ADJUSTMENTS
LAND
TOTAL
USE LOCAL
FROM
DEPTH
/ LND COND
ND NOTES OAUNIT
LAND
UNT TOTAL
ADJUSTED
LAND OVERRIDE LAND
CODEZONING
TAGE EPT SIZE
MOD FACT
RF AC LC TOOTTYPE
PRICE
UNITS
TYP AD]ST
UNITPRICE
VALUE VALVE
NOTES
ERZALBEST
AC 0120
297
0 2.3090
4 1.1000
+10 +00 +00 +00 +00 RP
6 700.0
1.14
AC 2.54
17 018.0
19503
0
AL MARKET LAM DATA
1.146 19,50AL
PRESENT USE DATA
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=F 100000046 4/14/2014
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All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the Implied
lW r warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the 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
5 of the use or inability to use the GIS data provided by this website.
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Printed:Apr 14, 2014