Loading...
1234 Godbey RdDavie County, NC Tax Parcel Report Fridav, October 7, 201 f WARNING: THIS 1S NOTA SURVEY Parcel Information Parcel Number: 120000000902 Township: Calahaln NCPIN Number: 5708889147 Municipality: Account Number: 82516012 Census Tract: 37059-801 Listed Owner 1: WRIGHT MARIAM O ' ' Voting Precinct: SOUTH CALAHALN Mailing Address 1: PO BOX 67 Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: Yes Legal Description: 11.04 AC GODBEY RD Fire Response District: COUNTY LINE,CENTER Assessed Acreage: 11.24 Elementary School Zone: WILLIAM R DAVIE Deed Date: 11/2000 Middle School Zone: NORTH DAVIE Deed Book / Page: 003510361 Soil Types: PaD,PcC2,RvA,CeB2,WATER Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 230310.00 Outbuilding 8r Extra 12920.00 Freatures Value: Land Value: 65680.00 Total Market Value: 308910.00 Total Assessed Value: 262190.00 At.V All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the 9 -xM Davie County, Imp[led warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the �T County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to UVII 1� C or arising out of the use or Inability to use the GIS data provided by this website. r Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780/Fax(336)753-1680 WELL PERMIT Account #: 990001439 Tax PINIEH #: 1200000011 Billed To: Mariam Wright Subdivision Info: Reference Blame: LocationtAddress: 1234 Godbey Road -27028 Proposed Facility: Public and Livestock W Property Size: 70 Acres p,T ctions 0 tf eompoyees 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 ® Repair ❑ Abandonment ❑ 6N Proposed Well Location Di Certificate of Completion Diagram o b� � 3 C i Comments: Driller: Q� Certification #: Grout Inspected: M �g Well Head Inspected: .e� t'�f GPS Coordinates: EHS: Date:EHS: l4 - ate: W.P. 7-08 APPLICATION FOR PRIVATE WELL PERMIT Davie County Environmental Health. P.O. Box 848/210 Hospital Street Mocicsville, NC 27028 (336)753-6780 / Fax (336)753-1680 * * *IjV1PORTANT* * * BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. APPLICANT INFORMATION Name !' Address t Z Contact Person _�P(2�0 Home Phone S, (, -L) qZ�S City/State/ZIP M Oe(C r) i N)o 2a�2 Business Phone --- Name on Permit if Different than Above Sbt .., ci�, Mailing Address P© '�ja�c G,� ' 1✓1 City/State/Zip AQ�K�c�; (� PROPERTY INFORMATION *Date House/Facility Corners Flagged NOTE: A survey plat or site plan must accompany this application. Included: lySite Plan-V,�Plat (to scale) Owner's Name m0. r-', �` Phone Number --Z - L 0-2-9 12 Owner's Address 12-3 L) Gcd.6 e,pica, City/State/Zip AXKKSo',, 1lPr Property Address S f p�� City _SN r-, F, Lot Size --() acypS Tax PIN# © R 192- Subdivision Name(if applicable) N Section/Lot# Directions To Site: "� lac ,,j�e F,c� bp,� fTn1 rd 1491t '(19 I Permit Type: New Well ✓ Well Repair Well Abandonment Other (specify) Facility Type: Residential Food Service Church Commercial Other Arc There Any Septic Systems Currently On The Site? YES NO _V - Do You Intend To Install A New Septic System On This Site? YES 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 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 perforin necessary field evaluations and procedures deemed necessary to determine the best location for a well. Signed �rrc>z� Z 0 000 C)p 1 1 7/30/09 Date Site Revisit Charge Datc(s): Client Notification Date: EIIS: Account ,lt' _ 3 Invoice 11 t7 Cl'"I.i� n L n GoMaps GIS 0-3131fI Page I of 6 -W SEA 0 - LU r {= http://maps.co.davie.nc.us/GoMaps/map/map.cfm?CFID=4129&CFTOKEN=61640881 9/14/2011 1. WELL CONTRACTfa1Rj RES`IDENTML WELL CONSTRUCTION RECORD North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION #_ 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 t 336) 468-4440 Area code Phone number 2. WELL INFORMATION: WELL CONSTRUCTION PERMIT# 12GOt-c,G0 OTHER ASSOCIATED PERMIT#(if applicable) SITE WELL ID #(if applicable) / 3. WELL USE (Check tApplica e Box): Residential Water Supply 19 DATE DRILLED ` O" ` TIME COMPLETED ' GU AM ❑ PMpf---, 4. WELL LOCA'T'ION: CITY: 8oChiy), e, COUNTY Q /t% r a 12j (Street Name, Numbers, Comm ity, Subdivision, Lot No., Parcel, Zip Code) TOPOGRAPHIC /LAND SETTING: (check appropriate box) []Slope ❑Valley❑Flat 2dLidg(e. ❑Other LATITUDE ISIt� �- dK7 "DMS OR DD LONGITUDE• 8C�'S-92 "DMS OR DC Latitude/longitude source: &Ws Qropographic map (location of well must be shown on a USGS topo map andattached to this form if not using GPS) 5. WELL OWNER - Al o an-, LJy 1'01\4 Owner Name Bottom 12-,? Y Thickness! Stre t Address c. WATER LEVEL Below Top of Casing: FT. 40G/1) V )J.(- , 2?02-k City or Town State Zip Code ( ) ' O3-- 2 `l 12 - Area code Phone number � / y _ t g.AAT}R'ZONES (dept : / Top 9.r f (1 Bottom 1 Top Bottom Top Bottom Top Bottom Top Bottom Top Bottom Thickness! 7. CASING: Depth �) % Diameter Weight Material Top_ Bottom V 5 Ft.�s- 10 1.21 Top Bottom Ft. Top Bottom Ft. 8. GROUT: Depth ` Materia4 Metho Top _ (�_ Bottom—L4 Top t BottoFtl.')'-n Top Bottom Ft. 9. SCREEN: Depth Diameter Tope Bottom_ Ft. in. Top ✓ Bottom Ft. in. Top Bottom Ft. in. 10. SAND/GRAVEL PACK: Depth Size Top Bottom �Ft. Top Bottom Ft. Top Bottom Fl. l l.iDRILLING LOG Top Bottom / ..Ut 73- 6U - / 12. REMARKS: Slot Size Material in. in. in. Material Formation Des �ptiory C< ,r curl f� c• i. �1 3�Ci� M t f ti �'u•i -a sc, n, iY' SIZE OFF BIT SERIAL NO: 6. WELL DETAILS: ��\ a. TOTAL DEPTH: b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO fVI DO HEREBY CERTIFYTHAT THIS WELL WAS CONSTRUCTED IN c. WATER LEVEL Below Top of Casing: FT. ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN (Use "+" if Above Top of Casing) 4-1 PROVIDED TO THE WELL OWNER. d. TOP CASING FT. Above Land Surface* � / y _ t 'Topp of casing terminated aUor below land surface may require 4 VZ � a variance in accordance with 15A NCAC 2C.0118. SIGNATURE OF CEF TIFIED WELL CONTRACTOR DATE e. YIELD (gpm): METHOD OF TEST 41 r1' w r () (/� ! t� �i ✓ 1!i f. DISINFECTIO : Type HTH _ Amount�_�S PRINTED NAME OF PERSON CONSTRUCTING THE WELL )�v►cvt . Submit within 30 days of completion to: Division of Water Quality - Information Processing, (corm GW -1a 1617 Mail Service Center, Raleigh, NC 27699-161, Phone : (919) 807-6300 l\� Rev. 2/09 r e._ Site Visited// -L3- /� BY: I i' Permit: r No , What Is Height of Well Casing? Make Sure 12" Above Ground Level!!!! BU=ERS NAME: ADDRESS: PHONE NUMBER: