FOR SIGNATURES, SEALS AND CERTIFICATES SEE SIGNATURES FORM by LeePenny

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									PLAN FORM 2 (APPROVED FORM 3)                                                                                  Plan Drawing only to appear in this space

SIGNATURES, AND SEALS ONLY                                                                                                                                                                                                                                            *




                                                                                                                                                                                                                                                                              * OFFICE USE ONLY
                                                                                                    To be added to final
                                                                                                    plan by surveyor                                             Registered:                                                                                          *
                                                                                                    before electronic                                            Title System:
                                                                                                    lodgment                                                     Purpose:
            FOR SIGNATURES,
                                                                                                                                                                 Ref. Map:
               SEALS AND                                                                                                                                         Last Plan:
             CERTIFICATES                                                                                                                                        PLAN OF
            SEE SIGNATURES
                 FORM                                                                                                                                            Lengths are in metres.                                          Reduction Ratio 1:

                                                                                                                                                                 L. G. A. :
                                                                                                                                                                 Locality:
       Crown Lands NSW/Western Lands Office Approval
                                                                                                    Where applicable,                                            Parish:
                                                                                                    details of approval and
I .....................................… … ..........in approving this plan certify
                                                                                                    the notation “SEE                                            County:
               (Authorised Officer)
that all necessary approvals in regard to the allocation of the land                                SIGNATURES FORM”                                                          This is sheet 1 of my plan in                                    sheets.
shown hereon have been given.                                                                                                                                                            (Delete if inapplicable)
                                                                                                    to be added to plan by
                                                                                                                                                                                          Surveyors (Practice) Regulation 2001
Signature: SEE SIGNATURES FORM                                                                      surveyor; signature of                                       I, .......................................................................................
Date: ......................................................................................        Authorised Person                                            of ......................................................................................
File Number: ...........................................................................                                                                         a surveyor registered under the Surveyors Act 1929, hereby certify
                                                                                                    together with details                                        that the survey represented in this plan is accurate, has been made in
Office: ....................................................................................        will be shown on the                                         accordance with the Surveyors (Practice) Regulation 2001 and was
                        Subdivision Certificate                                                     signatures form.                                             completed on.....................................................................................
I certify that the provisions of s.109J of the Environmental Planning                                                                                            The survey relates to ........................................................................
and Assessment Act 1979 have been satisfied in relation to                                                                                                       ..........................................................................................................
the proposed................................................................ set out                                                                             (here specify the land actually surveyed or specify any land shown in
herein                                                                                                                            All details and the notation   the plan that is not the subject of the survey)
                           subdivision’or ‘ road’
                 * (insert ‘                       new            )                                                               “SEE SIGNATURES
...............SEE SIGNATURES FORM...........................
                                                                                                                                  FORM” to be entered in         (Signature) SEE SIGNATURES FORM.... Dated:.........… .
       * Authorised Person/General Manager/Accredited Certifier                                                                   surveyors certificate by                    Surveyor registered under the Surveyors Act 1929
Consent Authority: .......................................................................                                        surveyor; surveyor's           Datum Line: … … … … … … … … … … … … … … … … … … ..
Date of Endorsement: ..................................................................                                                                          Type: Urban / Rural
Accreditation no: ..........................................................................
                                                                                                                                  signature together with
                                                                                                                                                                 Plans used in preparation of Survey/Compilation
Subdivision Certificate no: ............................................................                                          details will be shown on the
File no: ........................................................................................                                 signatures form.               PANEL FOR USE ONLY for statements of intention to
Note:
                                                                                                                                                                 dedicate public roads, to create public reserves, drainage
When the plan is to be lodged electronically in Land and Property
                                                                                                                                                                 reserves, easements, restrictions on the use of land or
Information, it should include a signature in an electronic or digital
                                                                                                                               Table of mm                       positive covenants
format approved by the Registrar-General.
                    S
SURVEYOR’ REFERENCE :                                                                                  WARNING CREASING OR FOLDING WILL LEAD TO REJECTION

								
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