F.8.

1
Pag. 1
.

_________________________________________

(DENUMIRE PROIECTANT)

(DENUMIRE SOCIETATE/REGIE
FURNIZOR/ADMINISTRATOR DE UTILITI URBANE)

FIA TEHNICA
n vederea emiterii Acordului Unic.
Aviz pentru bransament/racord
1. DATE DE IDENTIFICARE A OBIECTIVULUI DE INVESTIII
1. - Denumire________________________________________________________________________________
2. - Amplasament _____________________________________________________________________________
3. - Beneficiar ________________________________________________________________________________
4. - Proiect nr. ________________ elaborator _______________________________________________

2. CARACTERISTICILE TEHNICE SPECIFICE ALE INVESTIIEI

2.1. AMPLASAMENT:
____________________________________________________________________________________________
____________________________________________________________________________________________

2.2. BRANAMENT / RACORD:

____________________________________________________________________________________________
____________________________________________________________________________________________

2.3. CARACTERISTICILE TEHNICE CARE TREBUIE ASIGURATE PRIN PROIECT

____________________________________________________________________________________________
____________________________________________________________________________________________

3. MODUL DE NDEPLINIRE A CERINELOR AVIZATORULUI:

____________________________________________________________________________________________
____________________________________________________________________________________________

4. MODUL DE NDEPLINIRE A CONDIIILOR I RESTRICIILOR IMPUSE:

____________________________________________________________________________________________
____________________________________________________________________________________________

NTOCMIT
L.S.
5. Vznd specificrile prezentate n FIA TEHNIC privind modul de ndeplinire a cerinelor de
avizare, precum i documentaia depus pentru autorizare (PAC/PAD/POE), se acord:

AVIZ FAVORABIL
n vederea emiterii Acordului unic fr/cu urmtoarele condiii ___________________________________________
__________________________________________________________________________________________________
_________________________________________________________________________________________________
(*)___________________________________________________________
(SOCIETATEA/REGIA AVIZATOARE)

L.S.
Data: ______________

F.8.1
Pag. 2
PRECIZRI
PRIVIND COMPLETAREA FORMULARULUI "FIA TEHNIC"
pentru _____________________________________________
I. DATE GENERALE(**)
1. Baza legal

2. Coninutul documentaiilor
Certificatul de urbanism (copie)
Planuri de situaie/ncadrare n zon anex la CU
Titlul asupra imobilului (copie)

3. Durata de emitere a avizului

Se calculeaz la 15 zile calendaristice de la data depunerii documentaiei complete.

II. CONDIII I RESTRICTII SPECIFICE INVESTIIEI IMPUSE DE AVIZATOR:

(n funcie de tipul de construcie)

2.1. AMPLASAMENT:

2.2. BRANAMENT/RACORD:

2.3. CARACTERISTICILE TEHNICE CARE TREBUIE ASIGURATE PRIN PROIECT

III. INDICAII PRIVIND TAXA DE AVIZARE

a) Temei: _________________________________________________________________________________
_____________________________________________________________________________________________
b) - Valoarea taxei de avizare este de _______________________ lei.
c) - Modalitatea de achitare a taxei ___________________________________________________________
(CONT CURENT BANCAR, CONT C.E.C., etc)

IV. ALTE DATE FURNIZATE DE AVIZATOR

___________________________________________________________________________________________
___________________________________________________________________________________________