293 Willow Creek LnDavie Countv. NC
Tax Parcel Report Fridav, October 7, 201 f
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 p'� Davie County, 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
�oUN S4 NC or arising out of the use or inability to use the GIS data provided by this website.
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
G40000004903
Township:
Mocksville
NCPIN Number:
5820807773
Municipality:
Account Number:
28703250
Census Tract:
37059-806
Listed Owner 1:
GALE ALBERT D
Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1:
293 WILLOW CREEK LANE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-5880
Voluntary Ag. District:
No
Legal Description:
9.21 AC MAIN CHURCH RD
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
9.21 Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
1/2002
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
004030275
Soil Types: GnB2,GnC2,GaD,ChA
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
80180.00
Outbuilding & Extra
4900.00
Freatures Value:
Land Value:
60050.00
Total Market Value:
145130.00
Total Assessed Value:
145130.00
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 p'� Davie County, 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
�oUN S4 NC or arising out of the use or inability to use the GIS data provided by this website.
Davie County Environmental Health
P.O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax (336)753-1680
WELL PERMIT
Account #: 990002569 Tax PIN."EH #: G40000004903 Well
Billed To: Albert Gale.'Subdivision Into:
Reference Name: : LocationfAddress: 293 Willow Creek Lane -27028..
Proposed Facility: Residential Well Pftert.y Size: 9.21 Acres
ATC Number: 0114
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 Fd Repair ❑ Abandonment ❑
Proposed Well Location Diagram
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Comments: -/(/,► f) WLeGt fit- �� �� I��_ &0I
t
W.P. 7-08
Certificate of Completion Diagram
Driller: [a,l d 14W
Certification ff: a -h?
Grout Inspected:-
Well
nspected:Well Head Inspected:
GPS Coordinates:
EHS: Date:
• ` ( � '11.1
APPLICATION FOR PRIVATE VvT-LL PERMIT
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
2Mocksville NC 27028
C��
(336)753-6780 / Fax (336)753-1680
--"� ***IMPORTANT***
THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED.
APPLICANT INFORMATION
Name fia V
-r Contact Person
Address X 9,j Willow /a Home Phone 3,36 yg;- 6t3(,
City/State/ZIP & lo.e-. 0? ?o 8 Business Phone
Name on Permit if Different than Above
Mailing Address City/State/Zip
PROPERTY INFORMATION .*Date House/Facility Corners Flagged
NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat (to scale)
Owner's Name -A oto Phone Number
Owner's Address City/State/Zip
Property Addr ss City
Lot Size q. Z1 A&- Tax PIN# 4 0 00 0 b6 CM O 3
Subdivision Name(if applicable) Section/Lot# 7�
Directions To Site: 601 /jr `io 1�CQ,�� a,. ��;_ CSA", A e,. ZX�' "', o, I.err-T
DEVELOPMENT INFORMATION
Permit Type: New Well 1/ Well Repair Well Abandonment Other (specify)
Facility Type: Residential L/ 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 ✓
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 Date
Site Revisit Charge
Date(s):
Client Notification Date:
PPI(�/� j
Y V6(f Dr ll t iAli EHS:
7/30/09 / Account # 26(o�
PPV t d �rQ f -t �1 Invoice #
661-07-1 Y, tip
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 U C1 .l
Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of Printed: Dec 06, 2012
2
1 the use or inability to use the GIS data provided by this website.