Republic of the Philippines
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
Community Environment and Natural Resources Office
Region I, Bonuan-Tondaligan, Dagupan City
SUBJECT: Survey Authority for a tract Date: _______________,
of Public Land located in
Brgy. _________________,
____________________, Pangasinan
ENGR: Maritoni F. Esguerra
Geodetic Engineer
Sir/Madam:
Pursuant to DENR Administration order No. 2007-29 and upon evaluation of the request of ________________________________________, claimant of
the above described tract of public land who availed your services, authority is hereby granted to you to execute the survey subject to the relevant
provisions of the Manual for Land Surveys in the Philippines as Amended and conditions stated at the back hereof.
Violation of any of the aforesaid conditions shall invalidate this authority, and damages that may result therefrom shall be your sole liability and
professional responsibility.
Very truly Yours,
Conditions accepted: _______________, 20__ For and Authority of the
Secretary of DENR:
MARITONI F. ESGUERRA ENGR. NORIEL G. NISPEROS Signature/Name of G.E. OIC,
CENR Officer
License No. 10628
Issued on 11-06-19
Above stated request confirmed: Issuance of Survey
Authority Recommended
___________________________
Signature /Name of Claimant
______________________________
Address Land Management Officer III
Position/Designation
Ref. ________________________ Ref. ________________________
Inspection Fee Php ____________ Cad. Cost of _________________
Paid Under O.R. No. ___________ Paid Under O.R. No. ___________
Dated: ______________________ Dated: _______________________