PEMERINTAH KABUPATEN BELITUNG

KECAMATAN MEMBALONG
DESA MEMBALONG
Alamat : Jl. A.Yani Rt. 003 Rw.001 Dusun Membalong Desa Membalong Kec. Membalong
Kab.Belitung Kode Pos .33452

Nomor : 140/ /DS MBL/IX/2022 Membalong, 31 Agustus 2022

Sifat : Segera
Lampiran : 1 (satu) Berkas
Perihal : Permohonan Pertimbangan
Teknis

Yth. Kepala Dinas Energi dan Sumberdaya Mineral

Provinsi Kepulauan Bangka Belitung
di-
Tempat

Sehubungan dengan pelaksanaan kegiatan Reforma Agraria melalui

Kegiatan Pensertipikatan Redistribusi Tanah Tahun Anggaran 2022 yang
berada di Desa Membalong Kecamatan Membalong Kabupaten Belitung
sebanyak (daftar terlampir), dengan berdasarkan Peta RTRW Kabupaten
Belitung dan/atau berada dalam estimasi Izin Usaha Pertambangan (IUP)
dengan Pola Ruang Permukiman Pedesaan, Pertanian Lahan Basah dan
Pertanian Lahan Kering.
Sehubungan dengan hal tersebut diatas, kami mohon informasi bidang
tanah sebagaimana terlampir berada pada tahap kegiatan IUP Produksi atau
Eksplorasi dan rekomendasi dalam bentuk Pertimbangan Teknis apakah bidang
tanah tersebut dapat diterbitkan Sertipikat Hak Atas Tanahnya oleh BPN
(daftar bidang tanah terlampir).
Demikian disampaikan, atas perkenaan dan bantuan Bapak/Ibu kami
ucapkan terimakasih.

Kepala Desa Membalong,

(FIRMANSYAH)

Tembusan:
1. Kepala Kantor Wilayah Badan Pertanahan Nasional Provinsi Kep. Bangka Belitung di
Pangkalpinang;
2. Kepala Kantor Pertanahan Kabupaten Belitung di Tanjungpandan.
 SURAT PERNYATAAN

Yang bertanda tangan dibawah ini:

Nama : FIRMANSYAH
NIK : 1902020902830002
Jabatan : KEPALA DESA MEMBALONG
Dengan ini menyatakan bahwa:
1. Bidang-bidang tanah sebagaimana daftar terlampir yang terletak di Desa
Membalong Kecamatan Membalong Kabupaten Belitung menjadi objek
Redistribusi Tanah di Kabupaten Belitung tahun anggaran 2022;
2. Tanah yang dimohon sudah dikelola oleh masyarakat, sejak tahun 2010;
3. Tanah tersebut belum pernah dibebaskan oleh pihak manapun termasuk
pemegang IUP dan tidak dimiliki oleh pihak lain;
4. Pada lokasi yang dimohonkan tidak ada aktifitas penambangan.
Demikianlah Surat Pernyataan ini saya buat dengan sebenar-benarnya dan penuh
tanggung jawab.

Membalong, 31 Agustus 2022

Yang Membuat Pernyataan,
Kepala Desa Membalong

FIRMANSYAH
Lampiran Surat
Nomor : 140/ 113 /DS MBL/IX/2022
Tanggal : 31 Agustus 2022

Koordinat Lokasi Bidang

N
NAMA X Y
O
1 SUMANTO 806564,3507 9654465,558
806585,4674 9654425,603
806537,4386 9654457,367
806524,7039 9654493,67
806564,3507 9654465,558
2 JAMITUN 806544,6988 9654536,715
806588,0811 9654469,349
806564,8071 9654468,929
806513,5399 9654517,373
806544,6988 9654536,715
3 SUMANTO 806544,6988 9654536,715
806568,156 9654551,276
806604,0686 9654492,98
806588,0811 9654469,349
806544,6988 9654536,715
4 AHMA SARYATI 806792,2134 9655653,781
806799,5076 9655775,983
806850,7502 9655760,474
806840,5662 9655645,727
806792,2134 9655653,781
5 REZIE 806840,5662 9655645,727
806838,9879 9655541,478
806788,4692 9655548,501
806792,2134 9655653,781
806840,5662 9655645,727
6 SUDIRMAN 806789,492 9655497,455
806788,4692 9655548,501
806891,5941 9655519,779
806890,2362 9655470,553
806789,492 9655497,455
7 AKIDAH 806789,492 9655497,455
806890,2362 9655470,553
806888,833 9655419,683
806790,5144 9655446,429
806789,492 9655497,455
8 SUPIANTO 806718,4024 9655352,484
806765,0685 9655343,096
806760,2075 9655252,898
806702,6692 9655258,665
806718,4024 9655352,484
9 JUMHARI 806473,6984 9655630,619
806475,446 9655575,718
806392,8419 9655573,088
806392,9592 9655625,143
806473,6984 9655630,619
10 ADE PUTRA 806473,6984 9655630,619
806583,6398 9655621,318
N
NAMA X Y
O
806580,8212 9655579,072
806475,446 9655575,718
806473,6984 9655630,619
11 MIRHAD 806746,7979 9655658,346
806737,8497 9655559,748
806685,1439 9655571,853
806694,2829 9655672,154
806746,7979 9655658,346
804765,3636 9654357,868
804765,2548 9654470,023
804815,1259 9654464,727
804809,4686 9654354,86
804765,3636 9654357,868
12 JAAMAN 804765,2548 9654470,023
804765,3636 9654357,868
804722,473 9654360,793
804717,4654 9654361,417
804716,3005 9654475,222
804765,2548 9654470,023
13 JAMALIA 804716,3005 9654475,222
804717,4654 9654361,417
804669,5563 9654367,388
804668,5495 9654480,293
804716,3005 9654475,222
14 JAAMAN 804669,5563 9654367,388
804622,8885 9654373,204
804619,8619 9654485,464
804668,5495 9654480,293
804669,5563 9654367,388
15 AHMA SARYATI 804871,1456 9653024,836
804832,5958 9653030,012
804844,2622 9653084,255
804875,246 9653080,95
804871,1456 9653024,836
16 SUPIANTO 805053,1064 9653251,158
805054,6925 9653358,329
805062,1174 9653359,495
805075,3466 9653255,767
805053,1064 9653251,158
17 GITA UTAMI 795134,3005 9652511,517
795015,3942 9652566,912
795015,8545 9652576,826
795132,6817 9652572,788
795156,5372 9652553,799
795134,3005 9652511,517
18 TEGUH SANTOSO 795135,5269 9652507,4
795158,9279 9652551,896
795251,5907 9652478,136
795233,9402 9652452,729
795135,5269 9652507,4
19 GITA UTAMI 795114,5612 9652467,535
795135,5269 9652507,4
795233,9402 9652452,729
N
NAMA X Y
O
795208,8434 9652416,604
795114,5612 9652467,535
20 TEGUH SANTOSO 795134,3005 9652511,517
795112,7181 9652470,479
795013,0041 9652515,438
795015,3942 9652566,912
795134,3005 9652511,517
21 GITA UTAMI 795013,0041 9652515,438
795112,7181 9652470,479
795087,5855 9652422,691
795010,1537 9652454,049
795013,0041 9652515,438
22 TEGUH SANTOSO 795114,5612 9652467,535
795208,8434 9652416,604
795185,5193 9652383,03
795090,3815 9652421,559
795114,5612 9652467,535
23 GITA UTAMI 795088,033 9652420,351
795151,9935 9652394,448
795092,3735 9652281,247
795043,7644 9652318,543
795088,033 9652420,351
24 TEGUH SANTOSO 795043,7644 9652318,543
794998,2221 9652353,487
795010,0553 9652451,93
795088,033 9652420,351
795043,7644 9652318,543
25 SONIA 805168,3606 9654765,814
805155,7803 9654663,216
805140,9445 9654665,449
805091,9408 9654680,951
805112,9527 9654772,18
805168,3606 9654765,814
26 MARSIDI 805168,3606 9654765,814
805180,4309 9654816,955
805227,7025 9654809,982
805193,4834 9654657,541
805188,6568 9654658,268
805155,7803 9654663,216
805168,3606 9654765,814
27 SAHMIN 803939,9643 9653312,862
803947,3956 9653373,672
804014,86 9653372,644
804007,4963 9653309,166
803939,9643 9653312,862
28 SAHMIN 803939,1887 9653301,49
803973,2304 9653298,104
803967,7273 9653218,766
803936,1061 9653220,701
803939,1887 9653301,49
29 ASRI 803688,3272 9653796,824
803703,1922 9653819,383
803772,6658 9653802,161
N
NAMA X Y
O
803758,8302 9653773,894
803688,3272 9653796,824
30 ADE PUTRA 803742,2842 9653707,365
803773,547 9653796,824
803845,9144 9653788,078
803854,9007 9653701,514
803850,3421 9653741,166
803759,6787 9653756,035
803742,2842 9653707,365
31 YUSI YULYANTI 803804,6263 9653687,086
803742,2842 9653707,365
803759,6787 9653756,035
803850,3421 9653741,166
803854,9007 9653701,514
803804,6263 9653687,086
32 ASAN 803804,6263 9653687,086
803793,5675 9653593,795
803752,1518 9653601,201
803742,2842 9653707,365
803804,6263 9653687,086
33 APIPA 803716,1899 9653583,327
803720,35 9653634,033
803745,2407 9653639,71
803746,6025 9653575,543
803716,1899 9653583,327
34 SUPIANTO 803674,4307 9653416,024
803679,224 9653423,495
803757,4174 9653417,919
803759,9392 9653355,231
803674,4307 9653416,024
35 HINDRIAWANTO 807609,2291 9655099,781
807563,6347 9655103,71
807565,4376 9655178,107
807612,7882 9655177,612
807609,2389 9655099,996
807609,2291 9655099,781
36 TURSINA ENGGERAINI 807612,7882 9655177,612
807665,3804 9655177,062
807668,3031 9655094,691
807609,2291 9655099,781
807609,2389 9655099,996
807612,7882 9655177,612
37 HINDRIAWANTO 807665,3804 9655177,062
807740,0877 9655175,304
807742,883 9655131,988
807704,4662 9655131,607
807703,8858 9655090,829
807668,3031 9655094,691
807665,3804 9655177,062
38 MAHARAM 807563,6347 9655103,71
807609,2291 9655099,781
807668,3031 9655094,691
807666,4048 9654996,816
N
NAMA X Y
O
807591,9895 9655078,85
807563,6347 9655103,71
39 TURSINA ENGGERAINI 807666,4048 9654996,816
807668,3031 9655094,691
807703,8858 9655090,829
807702,1826 9655003,451
807701,7442 9654990,017
807666,4048 9654996,816
40 MAMAN SYAPUTRA 807742,883 9655131,988
807739,6833 9655004,525
807702,1826 9655003,451
807703,8858 9655090,829
807704,4662 9655131,607
807742,883 9655131,988
41 ARNA 807742,883 9655131,988
807771,3309 9655128,357
807779,2072 9655024,791
807783,3569 9655006,221
807739,6833 9655004,525
807742,883 9655131,988
42 MAMAN SYAPUTRA 807814,7459 9655126,884
807829,9086 9655027,696
807779,2072 9655024,791
807771,3309 9655128,357
807814,7459 9655126,884
43 MAHARAM 807814,7459 9655126,884
807855,4359 9655130,158
807877,0337 9655030,383
807829,9086 9655027,696
807814,7459 9655126,884
44 MAHARAM 807701,7442 9654990,017
807702,1826 9655003,451
807739,6833 9655004,525
807783,3569 9655006,221
807798,4747 9654940,062
807715,0488 9654939,773
807701,7442 9654990,017
45 TURSINA ENGGERAINI 807715,0488 9654939,773
807798,4747 9654940,062
807802,719 9654923,807
807811,022 9654875,882
807732,1376 9654875,237
807715,0488 9654939,773
46 AHMAD NUR 808490,2055 9653439,119
808482,606 9653512,938
808562,9182 9653503,649
808550,9165 9653436,18
808490,2055 9653439,119
47 DUAHAM 803950,9575 9655498,117
803914,8169 9655458,815
803820,4533 9655471,248
803844,9842 9655521,812
803950,9575 9655498,117
 N
NAMA X Y
O
48 SUGIANTO 803844,9842 9655521,812
803865,8031 9655564,725
803981,8262 9655531,686
803950,9575 9655498,117
803844,9842 9655521,812
49 DUAHAM 804012,832 9655565,404
803981,8262 9655531,686
803865,8031 9655564,725
803883,287 9655600,764
804012,832 9655565,404
50 SUGIANTO 803883,287 9655600,764
803885,8469 9655606,04
803914,5808 9655631,881
804046,9304 9655593,746
804033,903 9655588,318
804012,832 9655565,404
803883,287 9655600,764
51 DUAHAM 804077,5833 9655621,002
804062,6572 9655600,408
804046,9304 9655593,746
803914,5808 9655631,881
803944,7614 9655659,024
804077,5833 9655621,002
52 SUGIANTO 803970,713 9655687,408
804091,4976 9655660,502
804086,8691 9655634,633
804077,5833 9655621,002
803944,7614 9655659,024
803963,1925 9655675,599
803970,713 9655687,408
53 DUAHAM 803970,713 9655687,408
803997,9821 9655730,227
804095,4362 9655701,337
804091,4976 9655660,502
803970,713 9655687,408
54 ANISA MUSLIMAH 795708,9516 9653565,656
795691,9118 9653478,682
795655,8592 9653497,222
795679,6147 9653570,62
795708,9516 9653565,656
55 SEMAI 795882,6064 9653328,469
795837,6592 9653319,764
795815,8683 9653373,829
795749,4235 9653363,552
795745,5446 9653392,752
795828,1215 9653411,472
795849,0862 9653413,864
795858,8138 9653393,541
795882,6064 9653328,469
56 TIN YULIANTI 795858,8138 9653393,541
795902,1825 9653397,986
795921,5639 9653387,414
795947,4971 9653394,541
N
NAMA X Y
O
795959,2125 9653343,306
795882,6064 9653328,469
795858,8138 9653393,541
57 SEMAI 795959,2125 9653343,306
795947,4971 9653394,541
795980,7777 9653384,138
796044,4521 9653409,07
796048,7295 9653360,643
795959,2125 9653343,306
58 SEMAI 795751,3395 9653354,397
795810,7723 9653364,285
795833,7722 9653301,696
795807,547 9653269,09
795751,3395 9653354,397
59 HAMIM 804242,9866 9654398,719
804334,0718 9654366,492
804328,8929 9654318,4
804235,2491 9654349,134
804242,9866 9654398,719
60 MINA 804334,0718 9654366,492
804242,9866 9654398,719
804250,724 9654448,304
804339,2507 9654414,583
804334,0718 9654366,492
61 JAPAR 803984,0696 9654122,359
804052,5363 9654119,365
804059,2468 9654061,073
803977,3635 9654067,807
803984,0696 9654122,359
62 MARLINA 804059,2468 9654061,073
804057,0093 9653989,579
803966,4383 9653997,113
803977,3635 9654067,807
804059,2468 9654061,073
63 MERISIN 804275,0494 9654946,247
804119,7592 9654959,584
804120,8296 9654995,585
804279,6801 9654982,949
804275,0494 9654946,247
64 SAIDIN 804120,8296 9654995,585
804122,0558 9655036,831
804283,7516 9655015,22
804279,6801 9654982,949
804120,8296 9654995,585
65 DARA PUSPITA AYU RIZKI 794586,4694 9653471,239
794608,1192 9653556,776
794655,0363 9653543,173
794642,4533 9653448,632
794586,4694 9653471,239
66 ASAN 803780,4798 9653080,257
803679,1837 9653079,225
803660,1245 9653107,245
803779,6933 9653107,562
N
NAMA X Y
O
803780,4798 9653080,257
67 ROBI SUYATMA 803784,6231 9653024,492
803718,5877 9653015,625
803725,9018 9653031,536
803782,8867 9653045,057
803784,6231 9653024,492
68 ROBI SUYATMA 805126,9301 9654418,241
805195,939 9654401,901
805184,8575 9654371,588
805133,6593 9654372,395
805133,6904 9654374,37
805126,9301 9654418,241
69 SUWARLI 794846,6216 9651540,768
794781,7202 9651559,162
794797,6674 9651621,889
794802,9879 9651623,734
794806,5821 9651627,899
794870,1963 9651610,808
794846,6216 9651540,768
70 LUTFI GANGSAR PRAYOGO 794846,6216 9651540,768
794835,6637 9651508,212
794807,6474 9651474,982
794776,235 9651499,399
794744,5866 9651510,357
794742,2894 9651528,153
794677,863 9651534,998
794680,9425 9651548,31
794773,0799 9651525,176
794781,7202 9651559,162
794846,6216 9651540,768
71 ZAINUDIN 792247,9544 9650505,367
792295,7063 9650483,539
792239,3773 9650357,961
792184,4781 9650384,696
792202,6698 9650455,882
792241,4798 9650451,968
792250,4031 9650500,397
792245,5585 9650501,668
792247,9544 9650505,367
72 ZAINUDIN 792291,9003 9650320,563
792308,6463 9650365,675
792341,5808 9650353,516
792348,2008 9650375,947
792369,7429 9650371,151
792360,0575 9650345,764
792404,432 9650330,317
792384,4688 9650274,185
792291,9003 9650320,563
73 SUWETI NOBERTI 791819,9964 9650827,641
791803,3319 9650814,681
791779,8627 9650839,04
791757,1647 9650858,656
791788,1133 9650887,063
N
NAMA X Y
O
791805,6092 9650904,355
791820,6136 9650865,348
791851,4105 9650833,599
791819,9964 9650827,641
74 NAIMAH 794520,3349 9653764,443
794495,6039 9653776,878
794534,9374 9653846,606
794557,4748 9653836,807
794520,3349 9653764,443
75 AYU WULANDARI INDAH 809289,3167 9654404,674
PUJIATI 809324,9411 9654378,646
809266,5889 9654272,658
809230,6128 9654292,611
809269,7194 9654369,969
809289,3167 9654404,674
76 HERU PRUNOMO 795322,2073 9654295,553
795313,8898 9654295,093
795286,7746 9654308,645
795250,3624 9654332,52
795270,6633 9654396,851
795343,7735 9654373,551
795322,2073 9654295,553
77 NOPI KURNIAWAN 795286,7746 9654308,645
795313,8898 9654295,093
795297,1522 9654209,415
795292,8316 9654188,35
795278,7432 9654192,311
795286,7746 9654308,645
78 ISTI RAHAYU 795313,8898 9654295,093
795322,2073 9654295,553
795327,3951 9654297,17
795377,2403 9654290,969
795376,5726 9654262,891
795367,3886 9654200,013
795297,1522 9654209,415
795313,8898 9654295,093
804371,5894 9653329,813
804379,1441 9653235,825
804370,742 9653231,608
804348,4795 9653220,433
804347,4596 9653222,465
804331,9905 9653261,264
804311,2216 9653334,898
804356,53 9653332,853
804371,5894 9653329,813
79 SOPIA 804199,3367 9652983,586
804215,3351 9652921,045
804197,165 9652918,24
804185,4284 9652976,993
804185,9302 9652977,182
804196,3974 9652982,38
804199,3367 9652983,586
80 BEJO WARDOYO 808522,2245 9651866,547
N
NAMA X Y
O
808525,5697 9651871,797
808558,8742 9651924,07
808611,5012 9651896,849
808584,418 9651838,46
808580,2186 9651833,392
808577,7547 9651830,419
808522,2245 9651866,547
81 EDDY SUPRIYADI 807616,2094 9655499,497
807612,5276 9655554,106
807612,1469 9655558,115
807609,164 9655586,17
807651,9836 9655587,17
807661,1273 9655503,962
807616,2094 9655499,497
82 MAJIRIN 804371,589401 9653329,812710
804379,144131 9653235,825110
804370,741961 9653231,607770
804348,479463 9653220,433470
804347,459587 9653222,465370
804331,990488 9653261,264390
804311,221568 9653334,897660
804356,530036 9653332,852830
804371,589401 9653329,812710
804371,589401 9653329,812710
804379,144131 9653235,825110
804370,741961 9653231,607770
804348,479463 9653220,433470
804347,459587 9653222,465370
804331,990488 9653261,264390
804311,221568 9653334,897660
804356,530036 9653332,852830
804371,589401 9653329,812710
83 JAMALIA 804765,363607 9654357,867920
804765,254761 9654470,022900
804815,125869 9654464,726620
804809,468574 9654354,860400
804765,363607 9654357,867920
804765,363607 9654357,867920
804765,254761 9654470,022900
804815,125869 9654464,726620
804809,468574 9654354,860400
804765,363607 9654357,867920