Anexa nr.

1 Vizat
(coninut cadru P.U.Z.)
ef Secie,
.............................................

Proces verbal
ncheiat astzi ____/____/_________

Ref.: Plan Urbanistic Zonal privind includerea n intravilan a terenului amplasat n vecintatea
DN___ km. ______________________ partea___ n vederea construirii obiectivului:
_______________________________________________________________________________,
comuna/oraul/municipiul ____________________________, judeul _____________________
Proiect nr._____/_____________
Beneficiar: _______________________________________
Proiectant: _______________________________________

Subsemnaii:
- _________________________________, din partea Seciei de Drumuri Naionale _________________
- _________________________________, din partea S.P.R. - I.P.J._____________________________
- _________________________________, din partea beneficiarului _____________________________
ne-am deplasat pe DN ___ unde se dorete avizarea P.U.Z., constatnd urmtoarele:

1. Limita administrativ a comunei/oraului/municipiului ______________________:

- DN ___ km. _____________________________ partea___
- DN ___ km. _____________________________ partea___
- DN ___ km. _____________________________ partea___
- DN ___ km. _____________________________ partea___
2. Limita intravilanului existent al comunei/oraului/municipiului ______________________:
- DN ___ km. _____________________________ partea___
- DN ___ km. _____________________________ partea___
- DN ___ km. _____________________________ partea___
- DN ___ km. _____________________________ partea___
conform P.U.G. avizat de D.R.D.P. Iai cu avizul nr._________ din___/___/_______
conform P.U.Z. avizat de D.R.D.P. Iai cu avizul nr._________ din___/___/_______
3. Suprafaa terenului care se dorete a fi inclus n intravilan este de _________m2
4. Terenul care se dorete a fi inclus n intravilan este amplasat n vecintatea
DN___ km. ______________________ partea___cu acces rutier la DN___ km.___________ partea___
DN___ km. ______________________ partea___cu acces rutier la DN___ km.___________ partea___
5. n plan DN ___ se prezint astfel ______________________________________________
6. n profil transversal DN ___ se prezint astfel ________________________________________
____________________________________________________________________________________
_
____________________________________________________________________________________
_
____________________________________________________________________________________
_
(tip mbrcminte, dimensiuni: parte carosabil, acostamente, anuri)

7. Intersecii i accese rutiere existente n zon:

- DN ___ km. _____________partea___ cu ______________________________________________
- DN ___ km. _____________partea___ cu ______________________________________________
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 - DN ___ km. _____________partea___ cu ______________________________________________

8. Construcii/obiective existente n zona intravilanului proiectat:

8.1 ________________________________ n zona DN ___ km. ______________________ partea___
acces rutier la DN ___ km. ________________________ partea___ prin pode/rigol de tip
________________________, mprejmuire existent amplasat la _____ m fa de axa DN__
construcie existent de tip _____________________________ amplasat la _____ m fa de axa DN__
cu destinaia _____________________________ avnd ca beneficiar ____________________________,
aviz P.U.Z. nr.___________/____________, autorizaie D.R.D.P. Iai nr.___________/______________,
Meniuni privind respectarea prevederilor din avizul P.U.Z. i autorizaia D.R.D.P. Iai emise pentru
obiectivul i accesul rutier: ______________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

8.2 ________________________________ n zona DN ___ km. ______________________ partea___

acces rutier la DN ___ km. ________________________ partea___ prin pode/rigol de tip
________________________, mprejmuire existent amplasat la _____ m fa de axa DN__
construcie existent de tip _____________________________ amplasat la _____ m fa de axa DN__
cu destinaia _____________________________ avnd ca beneficiar ____________________________,
aviz P.U.Z. nr.___________/____________, autorizaie D.R.D.P. Iai nr.___________/______________,
Meniuni privind respectarea prevederilor din avizul P.U.Z. i autorizaia D.R.D.P. Iai emise pentru
obiectivul i accesul rutier: ______________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
8.3.etc.
9. Alte observaii i concluzii asupra traseului drumului ___________________________________
____________________________________________________________________________________
_
____________________________________________________________________________________
_
____________________________________________________________________________________
_

S.D.N. S.P.R. - I.P.J. Beneficiar

_________________ _________________ _________________

(nume, prenume, semntur, tampil) (nume, prenume, semntur, tampil) (nume, prenume, semntur, tampil)

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