310 Seaford RdDavie County, NC Tax Parcel Report Friday, October 7, 201 E
WARNING: THIS 1S NOT A SURVEY
Parcel Information
Parcel Number: K80000002006 Township: Fulton
NCPIN Number:
5776581672
Municipality:
Account Number:
8303987
Census Tract:
37059-804
Listed Owner 1:
MYERS RONALD L
Voting Precinct:
FULTON
Mailing Address 1:
310 SEAFORD ROAD
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:
LOT 7 SEAFORD ACRES SECTION ONE
Fire Response District:
FORK
Assessed Acreage:
2.87
Elementary School Zone:
CORNATZER
Deed Date:
8/2014
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
009650897
Soil Types:
PcB2,PcC2
Plat Book:
0006
Flood Zone:
Plat Page:
197
Watershed Overlay:
DAVIE COUNTY
Building Value:
186270.00
Outbuilding & Extra
18470.00
Freatures Value:
Land Value:
30760.00
Total Market Value:
235500.00
Total Assessed Value:
235500.00
'0 IAA6 `
�oi1ll
Davie County,
1� �T 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.
r Well Certification of Completion
Davie County Health Department
210 Hospital Street
1 P.O. Box 848
.'' .... Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Property owner: James and Lee Nolan
Address: 310 Seaford Rd
City: Advance
StatefZip: NC 27006
Phone #:
For Office Use Only
*CDP File Number 139447
PIN Number:
Tax Lot #: Tax Block #:
Evaluated For: WELL
Applicant: James and Lee Nolan
Address: 310 Seaford Road
City: Advance
StatefZip: NC 27006
Phone #:
Directions Drilling Contractor
Hwy 64 E. right on Hwy 801, Left on Riverview Rd. ,R,a,y,m,o,n,d, ,B,r,o,w,n, ,W,e,1,1, ,C,o, ,
Left on Seaford Driller Registration
,a31,,,�,,,,,,,,,,,,,
Date Drilled 0 7 / a 1 / 2 0 1 4 Replacement Well Q Yes No Total Depth Ft
Use of Well SINGLE FAMILY Static Water Ft
Yield gpm Water Zone 1) Ft 2) Ft 3) Ft 4) Ft
Chlorination Type: Amount:
Casing: Depth: 5 9 Ft Thickness In. Diameter 6 In Top of Casing 1 8 In.
Material PVC SCH 40
rout Depth Material Method Depth Material I
, To, . ,a . a 5 Ft BENTONITE PUMP From. . . . To. 3 . ,.OTHER N/A
From
From To Ft.
*Liner Date: / / _ From To R.
Grout Inspected by: EHS# 2325 -Mitchell, Brittany
Issued by. 2140 -Nations, Robert *Date:
Well Driller Signature
`Signature Date, 0 7 / a 1 / 2 0 1 4
0 7/ 0 1/ x 0 1 4
Location:
Tee (jet)
Yes
Comments
�No
Latitude
Longitude:
Suction Line
nYes
nNo
Enclosure
F]Yes
No
Temporary
nYes
E]No
Enclosure Floor
nYes
❑ No
Well I.D. Plate
nYes
nNo
Access Port
[]Yes
nNo
Pump I.D. Plate
F]Yes
[:]No
Vent
Yes
� No
EHS:
Bib Cock
Yes
F]No
Issue Date:
Back Flow
nYes
nNo
Water Sample
nYes
nNo
GHand Drawing OImport Drawing
WELL CERTIFICATE OF COMPLETION
Davie County Health Department CDP File Number: 139447
210 Hospital Street
WELL CERTIFICATE OF COMPLETION
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
CDP File Number: 139447
County File Number:
Date:
Click below to import an Image from an external location: Drawing Type: Well Certificate of Completion
•
Well Construction Permit
Davie County Health Department
;fit, t;�ti
210 Hospital Street
P.O. Box 848
'
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
f�Property Owner. James and Lee Nolan
Address: 310 Seaford Road
City Advance
State/Zip: NC 27006
Phone
.,- For Office Use Only
'CDP File Number 139447
PIN Number:
Tax Lot #: Tax Block #:
\ Evaluated For: WELL
t'CKIVII l VHLIU UH 1 IL. //l/ZUI�1
Applicant James and Lee Nolan
Address 310 Seaford Road
City. Advance
State/Zip: NC 27006
Phone ;�.
Property Location & Site Information
Address/Road w: Subdivision: Seaford Acres Phase: Lot: 7
310 Seaford Rd
'Proposed use of Well: drinking
Advance NC 27006
Directions If Other:
Site Address: 310 Seaford Rd Directions: Hwy 64 E. right on Hwy 801, Left on
Riverview Rd. Left on Seaford
Well Contractor Information
Drilling Contractor Driller Registration
Permit Conditions
'Permit Conditions
4(
'bVell location installation and protection must meet all state and local regulations and must be inspected and approve by an authorized representative of
the Local Health Department the permit may be revolted at any time for failure to comply with existing regulations The siting of the %yell by the Health
Department is to provide protection from the kno.vn possible sources of contamination The well site may not be c hanged 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 , 7 0 1 1 , a 0 1 1 4
�. eand Drawing 0Import Drawing
Authorized State Agent %;%go �/ ' _ ia— _ L- _ -$ * *
WkLL CONSTRUCTION PERMIT
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Drawing Type: Well Perrrait
� (R �(
CDP File Number: 139447
County File Number:
Date: 0 7 1 0 1 1 x 0 1 4
0 Inch
Scale: , , (i Block
,D N /A
f
0
��aRP beFbre�rorNg
j;LF,CF,1V9R PLICATION FOR PRIVATE W]�LL 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.
M
APPLICANT INFORMATION
Name -J / t3 ,P / , <0 / Cc h Contact P rson /�/o 1,6
Address (� �c� c� H�{ ! Home Ph ne 3 3 l — qyc — SS—f
City/State/ZIP A cJ v c vi c ,� Busine Phon 3 3G —46,,7 —1> 9... �— C;
Name on Permit if Different than Above
Mailing Address -31Q Seg(J�ol.City/State/Zip
PROPERTY INFORMATION
*Date House/Facility Corners Flagged
NOTE: A survey, plat o s e plan must accompany this application. Included: ❑ Site Plan ❑Plat (to scale)
Owner's Name L. Q 0,A Phone Number
Owner's Address City/State/Zip
Property Address�'o !Pd. City Act v,t *, e ..r
Lot Size Tax PIN#
Subdivision Name(if applicable) Section/Lot#
Directions To Site: 6 !V S ) o/ S,, c, -Zc- -.4 Z! n hiPy ,-vinv - Ac- %yi Sce-f'y^al
DEVELOPMENT INFORMATION
Permit Type: New Well V 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 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.
vJ ,
gned
7/30/09
G-2,6-sao
Date
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account # J
Invoice #
AUTNORIGAj'{6N NO: Q % Z 9 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee'.s, P.O. Box 848
Name:-��IL1��5'1Y10%✓� Mocksville, NC 27028 Subdivision Name: .
Phone #: 704-634-8760
Directions to property: ray Section:
AUTHORIZATION FOR ��r /
WASTEWATER Tax Office PIN:#J ✓ %/ D-
SYSTEM CONSTRUCTION --t--
Road
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
s IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH ECIALIST DATE ISSUE
RESII)ENTIAI: SPECIFICATION: BUILDING TYPE #BEDROOMS #BATHS,, �# OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE -j!dL TYPE WATER SUPPLY ^ 61//// DESIGN WASTEWATER FLOW (GPD) ��y NEW SITE l� REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE ZOD GAL. PUMP TANK GAL. TRENCH WIDTH FV ROCK DEPTH /J LINEAR FT. ?Db
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
I OPERATION
U
r -
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 6348760.
SYSTEM INSTALLED BY:
AUTHORIZATION NO.tj�4 OPERATION PERMIT BY: / ' � 1 DATE: ?_
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 1 I OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)