332 River Oaks Ln (2)3avie County, NC Tax Parcel Report Friday, October 7, 201 f
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WARNING: THIS IS NOT A SURVEY
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Parcel Information
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.
Parcel Number:
F90000004110
Township:
Shady Grove
NCPIN Number:
5890057651
Municipality:
Account Number:
8301251
Census Tract:
37059-804
Listed Owner 1:
JOYCE MICHAEL E
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
332 RIVEROAKS LANE
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006
Voluntary Ag. District:
No
Legal Description:
2.066 AC BAILEY RD TRACT 2B
Fire Response District:
ADVANCE
Assessed Acreage:
2.07
Elementary School Zone: SHADY GROVE
Deed Date:
7/2012
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
008970475
Soil Types:
WeB
Plat Book:
11
Flood Zone:
Plat Page:
69
Watershed Overlay:
DAVIE COUNTY
Building Value:
207600.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
26490.00
Total Market Value:
234090.00
Total Assessed Value:
234090.00
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Davie County,
NC
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.
Account #. 990005856
Billed To: Mike Joyce
Reference Narne:
Proposed Facility: Residential Wel
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax (336)753-1680
WELL PERMIT
Tax PKIEH #: F90000004103 - Site 2 Well
Subdivision Info:
:,.Location/Address: River Oaks Lane -27006
Property Size:% .,.Portion of 107
ATC Number: 0102
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 ❑ Repair ❑ Abandonment ❑
Proposed Well Location Diagram
Certificate of Completion Diagram
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Comments: wP-0 InPIA J lyoo
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Driller: Rt,Iw N,(/�
Certification #:
Grout Inspected:`
Vow 0"h 1 QZ ffio ollf
"Swkt
Well Head Inspected:
GPS Coordinates:
EHS: Date:
EHS: Date: 1
W.P. 7-08
419'// d
' APPLICATION 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***
THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED.
APPLICANT INFORMATION
Name ' c_k"_9 I Contact Person 1wife innc-a—
Address G GSA=L Home Phone 2 3
City/State/ZIP w - S ,fJC 27=�-/0 (o Business Phone ��✓3(0 Z 13�t}
Name on Permit if Different than Above
Mailing Address City/State/Zip S AJC-
PROPERTY
UC
PROPERTY INFORMATION
NOTE: A survey
Owner's Name_
Owner's Addres
*Date House/Facility Corners Flagged
site plan must accom an this application. Included: ❑ Site Plan ❑Plat (to scale)
(( ��( ('�,,j Phone Number a1 `(O -5`1
Property Address -p_j X W
Lot Size
Subdivision Name(if applicable)
Directions To Site:
City/State/Zip A,�-c T•� "Z
Tax PIN# '-80000004(03
Section/Lot#
I0)XTh1go) guy 1CO►1r1►1BIBUT 0016 1
Permit Type: New Well V/ Well Repair Well Abandonment - Other (specify)
Facility Type: Residential y Food Service Church Co inercial Other
Are There Any Septic Systems Currently On The Site? YES Ny
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 perform necessary field evaluations and procedures deemed necessary to
determine the best location for a well.
u
Signed
7/30/09
Date
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account #
Invoice 4
.RESIDENTIAL WELL CONMUMON RECORD
Norih Caroli m Depmtment of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR # NCWC 2241-A
1. WELL CONTRACTOR:
Reuhart William Clayton III
Well Contractor (Individual) Name
Aoua Drill Inc
Well Contractor Company Name
4137 Moores Mill Road
Street Address
Spencer VA 24165
City or Town State Zip Code
336 767-0747
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(# aW=ue)
SITE WELL ID #(if apocabre)
3. WELL USE (Check Applicable Boor): Residential Water Supply =
DATE DRILLED 5/ TIMECOMPLETED a !00 AM 0 PM ar
4. WELL LOCATION:
CITY:1)pe' s COUNTY
3 95' aFflcr 4 -Al Z"Z oo 6
(Sbeei Name. Numbers. Comrrnmdy. Subdivision. Lot Na. Parcel. Tip Code)
TOPOGRAPHic i LAN ErnNG: (dredc appropriam boo
❑Slope oVatley Cyrlat ❑Ridge DOther
LATITUDE 3@ 35- 57-'V/+ % " DMS OR 3X-V00000M DD =
LONGITUDE 7ff 90- //QQ' �- " DMS OR 7=00000= DD :
L1111MOUotude ,K -,PS ❑rop�sraph map
(tocacon ofweff must be snoxm on a USGS iopo map andalladied to
this form ffnot using GPS)
5. WELL OWNER
ctOsGC-
Owner Name
Street Address
City or Town State Zip Code
Area code Phone number
6. WELL DETAILS.
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NOpr�--
c WATER LEVEL Retow Top of Casing: !3 ,0 FT.
(Use'+' NAbove Topp (if Casing)
d. TOP OF CASING IS d Fl: Above Land Surface'
`Top of losing terminated allor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD Win): 1 METHOD OF TEST
L DISINFECTION: Type 6 %//700' Amount
g. WATER ZONES (depth):
Top_ i� D Botto►n_ � 3
Top_ Lzl_ Bottom LL
RECF/V
oc� Ea
201
UC
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C
HFgLTH
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Thickness)
7. CASING: Depth
Dw9eter
Ft 2.9'
Weight
X24 1
Material
PVG
Top—.b— Bottom
Top Bottom
FL
Top Bottom
Ft
8. GROUT: Depth
Top�Bottom Zit
Material Method
p
Top Bottom
FL
Top Bottom
Ft
9. SCREEN: Depth
Diameter
Slot Size
Material
Top Bottom
Ft in.
In.
Top Bottom
Ft in.
in.
Top Bottom
Ft in.
in.
10. SANDIGRAVEL PACK:
Depth
Sue
Material
Top Bottom
Ft
Top Bottom
FL
Top Bottom
FL
11. DRILLING LOG
Top Bottom
o 1 /-7
49 z s
�i ion
/07 / /-14
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12. REMARKS:
Formation Description
AC -0 gfz---'-v
HCl G T lr'
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN
ACCORDANCE WITH ISA NCAC 2C, WELL CONSTRUCTION
STANDARDS. AND THAT COPY OF THIS RECORD HAS BEEN
PROVIDED R THE YVE OWNER.
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SIGNATURE OF CERTIFIEQOELL CONTRACTOR 15ATE
Reuben William Clayton, ill
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit Within 30 days of completion to: Division of Water Quality - information Processing, Form GW -1 a
1617 Mail Service Center, Raleigh, NC 27699-161, Phone: (919) 807-6300 Rev, 2/09