282 Ralph RdDavie County, NC. Tax Parcel Report Friday, October 7, 201 f
i
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage;
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
39421350: Census Tract: 37059-804
IVEY PHILIP ALLEN Voting Precinct: WEST SHADY GROVE
134 LAKESIDE DR Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R -A
Land Value:
Total Assessed Value:
NC Zoning Overlay:
27006-0000 Voluntary Ag. District:
11.833 AC RALPH RD
Fire Response District:
CORNATZER - DULIN
11.68
Elementary School Zone:
CORNATZER
8/1998
Middle School Zone:
WILLIAM ELLIS
002040718
Soil Types: GnB2,MsC,ChA,MsD
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
30760.00
Outbuilding & Extra
0.00
Freatures Value:
70430.00
Total Market Value:
101190.00
101190.00
No
P•v!
'Q IAJ6
U -S
Davie County,
7�T
N1\ C
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
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.
Well Construction Permit
dro Davie County Health Department
t~.
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
4operty Owner: Phill Ivey
Address: 134 Lakeside Drive
City: Advance
State/Zip: NC 27006
hone #: (336) 998-4589
Address/Road M
282 Ralph Road
PERMIT VALID UNTIL: 10/7/2019
Applicant:
Phill Ivey ::::�l
Address:
282 Ralph Rd
City:
Mocksville
State/Zip:
NC 27028
Phone #:
(336)�118-4�589
Property Location & Site Information
Mocksville NC 27028
Site Address: 282 Ralph Road
Subdivision:
Phase: Lot:
*Proposed use of Well:
Directions If Other:
Directions: hwy 64 East, left on Cornatzer Rd. to Ralph
Rd is near Cornatzer Babtist Church. last drive to the
left on pavement
Well Contractor Information
Drilling Contractor Driller Registration
Y,a,d,k j,n, Xe jj, A r,i jj j,n,g, , , ,
Permit con
/ *Permit Conditions
Characters
Remaining
4000
Well location, construction 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 any time for failure to comply with existing regulations. The siting of approved well construction
area(s) by the Health Department is to provide protection from the known possible sources of contamination. The approved well area(s) may not be
changed without written permission from an authorized representative of the Local Health Department. No volume of quality of water is guaranteed by the
Health Department.
*Issued By: 2140 - Nations, Robert *Date of Issue; 1 , 0 / , 0 , 7 , / , .2 , 0 , 1 , 4
Authorized State Agen. ** ® Hand Drawing O Import Drawing
Site Plan/Drawing attached.**
Page 1 of 2
WELL CONSTRUCTION PERMIT
Davie County Health Department
210 Hospital Street
' P.O. Box 848
Mocksville NC 27028
i�'4nn M
pw�°
Drawing Type: Well Permit
CDP File Number: 158780
County File Number: 1-17-000-00-009-04
Date: 10 /07/.014,
Q Inch
Scale: O Block J
O N/A ft.
Page 2 of 2
P1 P3
APPLICATION FOR PRIVATE WELL PERMIT
Davie County Environmental Health j
P.O. Box 848/210 Hospital Street f
Mocksville, NC 27028 V
(336)753-6780 / Fax (336)753-1680 LO
* * *IMPORTANT* * *
THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
APPLICANT INFORMATION
Name P M ( l I: \.) �F- --( Contact Person _
Address I 34 l..t4-k€-SIO Home Phone
City/State/ZIP ri0y/} N( -Z t ,0, C. 2 ?DO& Business Phone
Name on Permit if Different than Above
Mailing Address City/State/Zip
PROPERTY INFORMATION
(0
�fO
TION IS PROVIDED.
*Date House/Facility Corners Flagged
S
NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat (to scale)
Owner's Name 241 L ztyiz y Phone Number
Owner's Address 5 AM,& City/State/Zip
Property Address ,Z 8 L %l,V4/'-11 City &70c1C.S
Lot Size //-921--45 Tax PIN# g-1
Subdivision Name(if applicable) Section/Lot#
Directions To Site: C' 0,WA-7-f-1/0 7-0 444" X,0
C'1J0'eCy Y 44 5 r A? Al!c. 7'y /— O 0J
I031WA S)aU100081Z1111CliUV ..-ViMto) eI
Permit Type: New Welly Well Repair Well Abandonment Other (specify)
Facility Type: Residential C/ 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 NO 1/
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.
c
Signed
7/30/09
/a�o Z/i V
Date
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account # b 7 yU
Invoice #
Z