Republic of the Philippines

DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS

REGIONAL OFFICE V
Regional Government Center, Rawis, Legazpi City

PERMIT TO ENTER

I, __________________________, of legal age, single/married, with residence address

at _________________________________, as the owner of the property described as
________________________________ situated in _______________________________, and
evidenced by __________________________________, hereby irrevocably, unconditionally
and absolutely authorize, permit, and allow the Republic of the Philippines acting by and
through the Department of Public Works and Highways (DPWH), its successors and assigns,
contractors and subcontractors, and agents and representatives unimpeded entry and unlimited
access to the said property and to conduct and undertake surveying, clearing and removal of
structures, improvements, crops, trees, and other items therein, soil test and other engineering
investigation, designs and pre-construction and actual construction activities as well as other
activities needed for or related to the design and implementation of the DPWH Project with
Contract ID No. 18F00073 entitled as Construction of Bypass and Diversion Roads, Juban-Bulan
Diversion Road (Bulan Section), including ROW, Bulan, Sorsogon.

________________________________
Name and Signature of Property Owner

ATTESTED BY: _________________________

DPWH Engineer