CERERE

PENTRU EMITEREA CERTIFICATULUI DE URBANISM

Subsemnatul___________________________________________________________________________________
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_______________________________________________________C.N.P. | | | | | | | | | | | | | |

domiciliul
municipiul
cu ________________ in judetul _______________________ orasul _____________________
sediul
comuna
satul _____________________________sectorul ____________________cod postal_________
strada ____________________________nr. _______bl._______sc._______et.______ap.______
telefon/ fax. _______________________ e-mail_______________________________________
In conformitate cu prevederile Legii nr.50/1991, privind autorizarea ex ecutarii lucrarilor de
constructii, cu modificarile si completarile ulteriore, solicit emiterea.

CERTIFICATULUI DE URBANISM
Pentru imobilul- teren si/ sau constructii- situat in judetul _______________________________
municipiul
orasul ___________________________satul _______________________sectorul ___________
comuna
cod postal ____________strada __________________nr. _____bl._____sc._____et. ___ ap.___
sau identificat prin ______________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________.
Suprafata terenului pentru care solicit certificatul de urbanism este de _____________________
Solicit certificatul de urbanism in scopul ____________________________________________
_____________________________________________________________________________
_____________________________________________________________________________.
Anexez: ______________________________________________________________________
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Data_______________

SEMNATURA