PROIECTANT

MIHALCEA CONSTANTIN P.F.

AUT. NR. F21/204/2005
FIERBINI, IALOMIA

MINISTERUL DE INTERNE
INSPECTORATUL DE PROTECTIE CIVILA
JUDETEAN IALOMITA
Str. Nordului, nr.1, Loc.Slobozia, jud
IALOMITA, Cod 8400, tel/fax: 043/235350

FISA TEHNICA
in vederea emiterii Acordului Unic
pentru avizul privind protectia civila,
1.DATE DE IDENTIFICARE A OBIECTIVULUI DE INVESTITII
1. Denumire____________________________________________________
2. Amplasament_________________________________________________
3. Beneficiar___________________________________________________
4. Proiect nr. ____________________ elaborator ______________________
2.CARACTERISTICILE TEHNICE SPECIFICE ALE INVESTITIEI (1) (in functie de tipul constructiei)
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3.MODUL DE INDEPLINIRE A CERINTELOR AVIZATORULUI(1)
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4.MODUL DE INDEPLINIRE A CONDITIILOR SI RESTRICTIILOR IMPUSE(2)
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_________________________________________________________________________________
INTOCMIT (2)
Ing. C-tin Mihalcea

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5. Avand in vedere specificarile prezentate in FISA TEHNICA privind modul de indeplinire a cerintelor
de avizare, precum si documentatia depusa pentru autorizare (PAC/PAD/POE), se acorda:
AVIZ FAVORABIL NR__________
in vederea emiterii Acordului unic fara / cu urmatoarele conditii(3):
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
(3)

____________________________
(nume, prenume, semnatura)

Data:___________________