Land Surveyor Work Verification Form 1999 printable pdf download

DEFINITIONS

Please refer to the statutes and regulations referenced.

AS 08.48.341(10) "practice of land surveying" means the teaching of land surveying courses at an institution of higher

learning, or any service or work the adequate performance of which involves the application of special knowledge of the

principles of mathematics, the related physical and applied related sciences, and the relevant requirements of law for

adequate evidence of the act of measuring and locating land, geodetic and cadastral surveys for the location and

monumentation of property boundaries, for the platting and planning of land and subdivisions of land, including the

topography, alignment and grades for streets, and for the preparation and perpetuation of maps, record plats, field note

records and property descriptions that represent these surveys;

12 AAC 36.065(b) "Responsible charge" of professional land surveying (P.L.S.) means work as a supervisor under the

responsible control of a land surveyor registered in the United States, and working in the “practice of land surveying” as

described in AS 08.48.341(11). The remainder of the required work experience listed in (a) of this section must be

derived from office or fieldwork involving the activities listed in AS 08.48.341(11). Partial completion of a curriculum

leading to a degree in land surveying will be considered by the board in determining applicable work experience. The

board will determine the amount of credit given for responsible charge experience gained under the responsible control of

a professional in engineering based on applicability to professional land surveying.

SUPERVISOR

NOTE: Was applicant continuously employed during calendar dates listed on reverse?

Yes

If not, give number of months of actual employment on this report:

SUMMARY (in Months)

(To be completed by Supervisor or Professional Licensee)

Months

Field Work Eligible as “Responsible Charge”

Office Work Eligible as “Responsible Charge”

Field Work Not Eligible as “Responsible Charge”

Office Work Not Eligible as “Responsible

Charge

TOTAL MONTHS OF SURVEYING EXPERIENCE (On This Page):

TOTAL MONTHS RESPONSIBLE CHARGE (On This Page):

If responsible charge experience is credited to the applicant, give a brief description of a typical project for which

applicant demonstrated professional judgment and responsible charge experience and the character of the duties

required by the project:

Typical Project Description:

PROFESSIONAL REGISTRANT CERTIFICATION

Name:

Place Professional Seal

Here

Signature:

Address:

City, State, Zip:

Date:

Telephone No.:

Registration No.:

State:

Were you licensed at the time of supervision?

Yes

NOTE: This document must be submitted directly to the Division by the Supervisor.

08-4412a (New 11/99)

Land Surveyor Work Verification Form 1999

Related Articles

Related forms

Related Categories