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828 Woodward Rd (2)Davie Countv. NC Tax Parcel Report Friday. October 7. 201 E WARNING: THIS IS NOT A SURVEY t.�1 �o(1r C4 Davie County, NC Parcel Information - Parcel Number: G400000015 Township: Mocksville _. NCPIN Number: 5830462815 Municipality: Account Number: 8302793 Census Tract: 37059-806 Listed Owner 1: 79 PROPERTIES LLC Voting Precinct: CLARKSVILLE Mailing Address 1: 6221 RAMADA DRIVE Planning Jurisdiction: Davie County City: CLEMMONS Zoning Class: DAVIE COUNTY R-A,H-B-S State: NC Zoning Overlay: Zip Code: 27102 Voluntary Ag. District: No Legal Description: 647.663 AC WOODWARD RD Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 645.70 Elementary School Zone: WILLIAM R DAVIE Deed Date: 11/2013 Middle School Zone: NORTH DAVIE Deed Book / Page: 009430893 Soil Types: MrC2,MrB2,SeB,GnB2,GnC2,EnB,EnC,MsC,ChA,MsD,WATER Plat Book: 0005 Flood Zone: Plat Page: 107 Watershed Overlay: DAVIE COUNTY Building Value: 270920.00 Outbuilding & Extra Freatures Value: 684040.00 Land Value: 1501040.00 Total Market Value: 2456000.00 Total Assessed Value: 1266620.00 t.�1 �o(1r C4 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. Well Construction Pen*AXED --- Davie County Health Department 210 Hospital Street Date: P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Property Owner: 79 Properties LLC Address: 6221 Ramada Drive City: Clemmons State/Zip: NC 27012 Phone #: (913) 426-2266 For Office Use Only 'CDP File Number 139454 PIN Number: Tax Lot #: Tax Block #: Evaluated For: WELL PERMIT VALID UNTIL: 7/18/2019 Applicant: Mike Wilkes Address: 232 Carrington Lane City: Winston-Salem State/Zip: NC 27127 Phone #: (336) 414-4120 Property Location & Site Information Address/Road #: Subdivision: 828 Woodward Rd. Mocksville NC 27028 Site Address: 828 Woodward Rd. Phase: Lot: 'Proposed use of Well: Directions If Other: Directions: hwy 158 East, left on Main Ch Rd. right on S. Angell Rd. Left on Woodward, cross 140 long drive off tc right Well Contractor Information nllin((xContractor Driller Registration --FL-/4 Permit conditions 'Permit Conditions 41 Well location, construction and protection must meet all state and local regulations and must be inspected and approved by an authonzed representative of the Local Heath Department. The permit magi 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; 0, 7,/ 1 1 1 8 1/ : 0 1 1 4 Authorized State Agent:©Hand Drawing O Import Drawing r Site Plan/Drawing attached. WELL CONSTRUCTION PERMIT 139454 a Davie County Health Department CDP File Number: 210 Hospital Street P.O. Box 848 County File Number: Mocksville NC 27028 Date: 0 7/ 1 8/ x 0 1 4 �VWMVol Q Inch Drawing Type: Well Permit Scale: OBlo k = O ft. tA le b c � *JI-41011-ke ., APPLICATION FOR PRIVATE WELL PERMIT Davie County Environmental Health Dem' P.O. Box 848/210 Hospital Street gecowed 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 1;1/A15' �/I�/� Contact Person Address Home Phone City/State/ZIP lig/' S r L 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 '%�1 P/L�ooE2�iES LGC— Phone Number 9 3 V26 411- Owner's 16Owner's Address a Z 1 pti City/State/Zip (f 7,-7 o r e Property Address City �1 oc�c S yr c c Lot Size Lgg--o t Tax PIN# Subdivision Name(if applicable) Section/Lot# Directions To Site: 113XT/2109)okyj1CI►181L41ice) O&V14 O)eI Permit Type: New Well t/ Well Repair Well Abandonment Other (specify) Facility Type: Residential Food Service Church Commercial Other Are There Any Septic Systems Currently On The Site? YES _t,, NO Do You Intend To Install A New Septic System On This Site? YES _jel 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. 7/30/09 7//S- / �� -- Date Site Revisit Charge Date(s): Client Notification Date: EHS: Account # Invoice #