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HomeMy WebLinkAbout27 Survey MonumentsPage 1 of 2
April 5, 2024
INSTRUCTIONS FOR COMPLETING THE APPLICATION AND PERMIT TO
REMOVE OR DESTROY A SURVEY MONUMENT PER WAC 332-120-070
_______________________________________________________________________________________
•IMPORTANT: An Application And Permit To Remove Or Destroy A Survey Monument is
intended to cover only one section. Separate permit forms must be submitted for each
individual project Section. However, multiple monuments may be referenced within a given
Section, provided that, indexing, monument descriptions, locations, and reference points
for each monument are shown on attachments.
•A minimum of three (3) reference points (RPs) must be in locations visible to the monument
and in areas which are not expected to be disturbed by construction activities.
•All re-set monuments MUST comply with RCW 58.09, The Manual of Survey Instructions as
applicable, and local county or city standards.
SURVEYOR INFORMATION
•Enter the name, company name, phone number, and email address of the Licensed Surveyor
who will stamp this application.
•The Licensed Surveyor must stamp (seal) and sign, in the area designated (on the first page
only) and enter the date in the box below the stamp. Please note that the boxed area for
the seal is set up to accept an electronic insert in several different file formats.
AT THE REQUEST OF (RESPONSIBLE PARTY) WAC 332-120-030(2)
•Enter the name of the company or agency name of the Responsible Party. The Responsible
Party is defined in WAC 120-030(2) as, “Any person, corporation, association, department, or
subdivision of the state, county or municipality responsible for an activity that may cause a
survey monument to be removed or destroyed shall be responsible for ensuring that the
original survey point is perpetuated.”
•Enter the contact’s name, phone number, and email address of the contact for the Responsible
Party.
PROJECT INFORMATION
•FOR PROJECTS WITH MULTIPLE MONUMENTS, ATTACHMENTS MUST BE USED TO SHOW
INDEXING, DESCRIPTIONS, LOCATIONS, AND REFERENCE POINTS FOR EACH MONUMENT.
•Enter the Estimated Completion date, which is the anticipated date for when the
monument(s) will be reset or will no longer be threatened by construction activities. This
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April 5, 2024
date can be revised, if needed, as it is an estimate. If this date needs to be extended
(revised) please contact the PLSO via email, at plso@dnr.wa.gov.
•Enter the county or counties in which the monument is situated.
•Provide indexing information (Township, Range, Section, Quarter [not 1/16th]).
•Enter the Washington Plane Coordinate System coordinates for search purposes.
•For multiple monuments, list coordinates for each in the “Comments” section or on
attachments.
•Specify the Coordinate Source, such as “measured”, “published City GIS”, “Google Earth“,
“phone app”, etcetera. For projects with multiple monuments, coordinates must be
shown in the “Comments” section or on attachments.
ANTICIPATED REPLACEMENT MONUMENT DESCRIPTION AND OTHER COMMENTS
•Enter the anticipated description of the permanent monument to be placed upon
completion.
•Enter any additional indexing, monument description, GLO designation (as applicable), or
information that would aid in the intelligent interpretation of the work to be accomplished.
_________________________________________________________________________________________________________________________
ATTACHMENT INFORMATION
EACH ATTACHMENT MUST SHOW:
•General location aids, as applicable:
o Road names and intersections (or distance to nearest road intersection).
o GLO designation (if applicable) OR distance and bearing to nearest GLO corner.
o Reference survey map, or plat name, block, lot, etcetera.
o Any other information that would aid in the intelligent interpretation of the location
of the monument and RPs, such as power pole number, address, building corner,
etcetera.
•A detailed description of the monument and accessories found marking the position of
the existing monument.
•The temporary references set or existing reference monuments to which
measurements have been taken to reestablish the destroyed monument to its original
position.
•Bearings and distances from the monument to-be-removed to the reference points.
•Any narrative, sketch, or photo that would aid in the intelligent interpretation of the work
being accomplished.
APPLICATION AND PERMIT TO REMOVE OR DESTROY A SURVEY
MONUMENT PER RCW 58.24.040(8) AND WAC 332-120-070
DNR PERMIT NO:DATE:
SURVEYOR INFORMATION
AT THE REQUEST OF (RESPONSIBLE PARTY) (WAC 332-120-030(2))
SURVEYOR NAME:
COMPANY NAME:
PHONE NUMBER:
EMAIL ADDRESS:
SIGNED PLS SEAL:
DATE:
COMPANY/AGENCY:
CONTACT NAME:
PHONE NUMBER:
EMAIL ADDRESS:
1st County:2nd County:
N: E:Datum (e.g., NAD83):Zone:
T:
Washington Plane Coordinates: (for search purposes)
R:
W
S:1/4:
E
PAGE 1 OF:
You are hereby authorized to
remove or destroy the herein
described survey monument:
THIS SECTION FOR
PLSO USE ONLY
Anticipated Replacement Monument Description and Other Comments:
(Form prescribed 04/05/2024 by the Public Land Survey Office, Dept. of Natural Resources, pursuant to RCW 58.24.040 (8))
PROJECT INFORMATION
Estimated Completion:
Coordinate Source: