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330 Woltz Ln (2) �avie County,NC Tax Parcel Report Tuesday, October 4, 201 f ; _ , �'r'� �, �: i�� ,I _ � , r i � r� r �: � ;; ��o �;'� � ...,.,,WO�7- � � �`, ��-N ----�----------' �' 5; . .. . . '�ti* �5"i w�. �`l �� t�. ry~^�'� �`S JL�� \\ �� it ��. x �� $,� '� �'}�;. :�, �� * �� ;.§_ .. ... ... . ..-- .. ......... "- � - WARNING: THIS IS NOT A SURVEY _ .vA��.��.�.�..,_.. � _.�,,�„� ��,.,_,..�.,..._..v,_.x�..�. _.�,�.��.,�,_�..,,_;__.�� _ _y Parcel_Information _ _ _v .,�t__� Parcel Number: 190000000604 Township: Shady Grove NCPIN Number: ", 5798290651 Municipality: AccountNumber: 8303051 Census Tract: 37059-804 _ Listed Owner 1: MOTSINGER MATTHEW`' .- Voting Precinct: EAST SHADY GROVE Mailing Address 1: PO BOX 2033 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: 10.000 AC TRACT 6 OFF BURTON RD Fire Response District: ADVANCE Assessed Acreage: 10.00 Elementary School Zone: SHADY GROVE Deed Date: 12/2013 Middle Schooi Zone: WILLIAM ELLIS Deed Book/Page: 009470938 Soil Types: AaA,Pc62,PcC2,RnD,RvA,ChA,WATER Plat Book: 11 Flood Zone: Plat Page: 269 Watershed Overlay: DAVIE COUNTY Building Value: 178760.00 Outbuilding 8 Extra 0.00 Freatures Value: Land Value: 85440.00 Total Market Value: 264200.00 Total Assessed Value: 264200.00 9[•�1�, All daW is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not Ilmited to the Davie County� Implled warcanUes ot merchantabiiity or fltness for a particular use.All users ot Davle County's GIS webslte ahall hold hartnless the County o(Davie,North Carolina,Its agenb,consultanb,contractora or employees from any and all elaims or eauses of action due to �p UN'�� NC or arlsing out of the use or Inability to use the GIS daW provided by thls website. � Yrcu VVIIi�t1 UI.lIV1/ I�GIIII il - - - - - - � f e,,¢„t, _ Davie County Health Department - ; *CDP File Number ;'139$94 � ��Q�� 210 Hospital Street � , �f� _ . PIN Number �` r _�� P.O. Box 848 ' � ' . �'��i� Mocksvilie NC 27p2g Tax Lot#: Tax Block# Phone: 336-753-6780 Fax:336-753-1680 �.Evaluated For: WELL ` - PERMIT VALID UNTIL: g!6/2019 Prope�ty Owner: Matthew and.Melinda Motsinger App�icant: Wishon & Carter Builders, INc Address: PO Box 2033 Address: PO Box 1719 City: Advance ��Y� Yadkinvi(le State2ip: NC 27006 State�Lip: NC 27055 Phone#: Phone#: (336) 679-2032 Property Location & Site Information Address/Road #: Subdivision: Phase: Lot: g Woltz Lane =Proposed use of Well: Advance NC 27006 Directions if other: Site Address:Woltz Lane Directions: Hwy 64 East left on Hwy 801,got to Peoples Creek Rd.on right beside Elbaville Ch.the right on Burton Rd. Left on Waltz Lane Lot off to right. Well Contractor lnformation Drilling Contrador Driller Registra6on . . L� c,��-k, r�,( , ,f.,a t� , �- �, �,-p, v , , � , . � , � � , , � � . � , � . , , , � , . � � Permit Conditions `Permit Conditions �,. ,,., 41 Well location,constr�uctlon and protection must meet alt state and local regulations and must be inspected and approved by an auhorized representatNe of the local He�th Department.The permit may be revoked atarry bme for failure to complywith e>dsGng regul�ions.The siting ot appro�ed welt construction area(s)by tl�e He�th Oepartment Is to provide protecUon from the knavn possib►e sources ot contamir�ation.The approve0 vaeU area(s)may not be changed : witho�6 wntten permission irom an a�thonzed►epr�esent�ive of t�e Laal Heatth Dep2rtment.No vdume of qu�iry of water is guaranteed by the He�th Department. :Issued By: 2�40-Nations, Robert �Date of Issue, � , 8 , 1 , � , 6 , � , a , 0 , 1 � 4 � OHand Drawing Olmport Drawing Authorized StateAgent: �*Site PIanlDrawing attached.�'� ,- ��,,,�6 �d��e �uun�y �ed�� eNa�ur�eni �ur rne Numoer: •�� . ��''d �'�"' � ' 210 Hospital Street �r�� , � �A, Box 84s County File Number: � 4�, _ . � • � Mocksville NC 27028 Date: � $ � 0 6 / � 0 1 4 �� Q fnCh Drawing Type: Weli Permit � Scale: . . QBiock _ �N�,�, �ft. _ ._ .. . . _ _.. . . � _ . _.. . . _ _ �,,_ _. _ _ _.�,___ __ V } .. _ _ , _ _ . . __. _�c._ . _: _ V�- .__�` . . . _ . _ _ ._ _ _ _ _ _ l��- .__ :_. .. - -- � :_ ___ . __ _ _ __ , � . _ . _ _ : _ _ _ _ : _ ._ _: . __.__ ___�___. .� : � �y �� _ . _ . _ . - --- . ___ . __ _ _ ._ _ _ _ _ 3aa . , _ .� ,._:.. .,._..--- .. .._ _._....... __ _ . _ _ . . . . ,,� ��t � . _. _ _ � , _ _ .. ..._� ._.,. .__ __ _ .__�. . .__ _ . _ . _ . ' . . ._ _ _ _ _. .. _.� ,___.. � :_ ._ ... __ _ � _ �_. _--_ ____ _ __ . _ _ . . _ _ _ :'��_v�.. .....,. :__ _. ._ .. . _ _ e � :�: . . _ _ . _ ._ _. .__ _. . . . .�.J . ,_�_ _ . _ � _ . ___ . _ _ �' _ _ _ _ ..... .__...._ _ _ __ _ _ _ __ ..�� __ _ _ ___ ____ __ _- .__.,_ � _ � _ N _ _ _ _ _ _ __ __ __ _ . _ . _. - � .�. , \o . ! , _ . i3 _ _ _ . r Page 2 of 2 ` 07/31/2014 08:58 3367531680 DCEH PAGE 01/�1 , . . _ • . PAID �ppLICATION FOR PRTVATE WELL PERMIT Dau: 7�3��y Davie County FnvironmentaI Aealth f� REC��V�D 1'.O.Box 848/2ID Hospit�l Street R rs � / MoClcsvf��e,NG 27028 Date: 7 '3� �C� (33G)753-G780 i Tax(336)753-1G80 F� . "*w.I117PORTAN7i4** THIS APP�.TCATION CANNOT73E P,ROCESSF..D UNLESS AT.L QF THE REQUIRED INFnRMA'I'TON IS PROVI3�ED. A.�PLICAN'Y'INFORMATION Name �3i 1�,,.,,a�G��-'" 81� w� ContactPerson �la� ��b� Address o Qa 1l`I Home Phone City/State/ZIp •'�t�S I�;,.c�.11�, NL �'�oS`-- '�1"� Business Phone_ 33�_- G,''!g_ ��3�_ Nata�e on Permit if D�erent than Above iv�ailing Address�_ City/Statc/zip P1tOPER�'X�ORM,A.7'[ON *Date House/�ac�lity Cozx�ers�lagged '�.-i1'_i� NOTE: A survey pTat c,r site plan must accoTapan,y ttus application. Jncluded: Ct 9ite Plarx ❑�lat(to scale) Owner'sName ('`�a.�+e..� �' M��e�S�. Ma�- ; � PhoneNumbez Owner's Addreas d �3a�. �d.�2 . ____City/State/Zi�._Q��'ouce N L. ��04, PropertyAddress I..a�l � W�s�� -nN.�- CxtY �d�r+:�+�- � Lot Sir.e lo ��, Tax P1N# �`lg 8-?.9 a �Sl ' Subdivision 1Vnme(ifapplicflble) Section2ot# T�irections To Site: QO) S ; �.e�a�+ i-•ol < CR,ck _'s�. ��v 3�•-�o..i ��-e�o� Wo t'�z_�e,�,..�_ �e�oy e--:�� DEVEL4PIv�NT IN�'O�tMATION Pctmit'�'ype: New Well `� Well Re�air Well Abandonment Othcr(s�cca�'y) Facility Type: Rcsidcr�tial ✓ Food Sexv�ice Churcb Commercial Other Are There Any Scptic Systcros Currently On The Site? YES NO '� Do You�ntend To Install A New 5eptic System On This SiteT YES ✓ NO TERMS ANL)CONDITIONS: This applicatidn must be�ccompanied by a plat or site pinn of the propexty tbat iuAcludes the existing�nd proposed propexty lines with dimension3,the speeifie loc,�►tion of thc faeility and a�.y existing or future appurtcnances,tbe Ivcatio�o�arry exist'tng septic systcm�sewer lines,water lines,arry cxisting watcr supplies and any surface waters. 'The applicant is r�,tponsiblc for identi�'ying and marking the property li»es and comers. 1'he appIicant is responsible for making thc site acccssiblc. By signing this applxc�tion,the applicant signifies that they undcrstand the terms Rnd conditions and that they give permission far Davic County Fnvironmezztnl Health representatives to perform ncccssary f eld evaluations and procedures deemed necesstuy to detcrminc the best loc��i�n far a wcli. � �� h 3 �—�y Sigtted Date Site Revisit Charge Datc(s): Client Notificarion Datc: EHS: ��p�pg Account# Invoicc# e�a# ��g�Y-� sC�o�;c.