2. PLAN IDENTIFICATION
SURVEY PLAN
SUBMISSION TO SURVEYOR GENERAL
LAND TITLE AND SURVEY AUTHORITY PAGE OF PAGES
By incorporating your electronic signature into this electronic plan, you:
(a) represent that you are a subscriber and that you have incorporated your electronic
signature in accordance with section 93.93(3) of the Land Act, RSBC 1996, c.245; and
(b) certify the matters set out in section 93.93(4) of the Land Act.
Each term used in this representation and certification is to be given the meaning ascribed
to it in Part 7.2 of the Land Act.
1. BC LAND SURVEYOR IDENTIFICATION: (Name, address, phone number)
Deduct LTSA Fees? Yes
2. PLAN IDENTIFICATION:
Plan Type: Grid:
Plan Number: Control Number:
This original plan number assignment was done under Commission #:
Survey Type:
LOCATION:
Quarter Unit: Exception: Unit: P&NG
Block: P&NG Group: - -
Land District:
LOCATION:
Exception: LS: Section:
Township: Range:
Meridian:
3. PARCEL IDENTIFICATION AND LEGAL DESCRIPTION OF PARCEL(S) AS DESIGNATED BY THE SURVEYOR GENERAL:
[PIN] [LEGAL DESCRIPTION]
4. CERTIFICATION:
(YYYY/Month/DD)
The checklist was filed under ECR#: on this date: (YYYY/Month/DD)
5. ALTERATION:
This is an alteration to a previous version of this plan identified by control number:
DESCRIPTION OF ALTERATION:
FORM_CLRS_V18
1
2
Import Profile
Land Act
Survey Plan
USE SCHEDULE
The field survey was completed on:
01
2015
January
2015
January
01
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signature
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SURVEY PLAN SUBMISSION PAGE OF PAGES
6. PLAN DATA:
This plan is a re-survey? Yes No Previous Plan Number:
Agency Name: Agency File Number:
Agency Name: Agency File Number:
Agency Name: Agency File Number:
Survey Method: Scale: 1:
Surveyor's Reference:
Well Authority Number: Well Site Name:
7. EXPLANATORY NOTES:
8. PLAN CONFIRMATION:
(YYYY/Month/DD)
9. NOTES ADDED TO THIS PLAN BY THE SURVEYOR GENERAL:
2
2
Field survey
ADDITIONAL FILE NUMBERS
USE SCHEDULE
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signature
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