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Cerere soluţie tehnică - Compania de apa Arad

Cerere soluţie tehnică - Compania de apa Arad

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JUDEŢUL ARADS.C. COMPANIA DE APĂ ARAD S.A.RO-310178, ARAD Str. SABIN DRĂGOI Nr. 2-4, ROMANIAC.I.F: RO-1683483; Nr.O.R.C.: JO2/110/21.02.1991Capital Social subscris si varsat 9.274.000 RONTel. +40-257-270843; +40-257-270849; Fax. +40-257-270981E-mail: <strong>apa</strong>canal@caarad.roNr. ............../......................Se aprobaDir. generalIng. GHEORGHE BANATEANCEREREDE BRANSARE / RACORDARE BRANSAMENT APA RACORD CANALSubsemnatul ...............................................................,domiciliat in .......................................,str.....................................................................,nr...........,bl.......,ap..........,telefon...............................Prin prezenta solicit solutia tehnica pentru un bransament <strong>de</strong> <strong>apa</strong> / racord <strong>de</strong> canal ,pentru imobilulsituat la adresa : loc. .................................,str..............................................,nr....................Necesarul <strong>de</strong> <strong>apa</strong> este solicitat pentru :a) - consum casnic;b) - uz gospodaresc ;c) - activitati productive ;d) - alte nevoi.Anexez la prezenta cerere urmatoarele documente ( in copie);- copie act <strong>de</strong> i<strong>de</strong>ntitate (BI,CI);- titlu <strong>de</strong> proprietate ( CF,sau contract vanzare / cumparare);- codul unic (pentru agenti economici) ;- act <strong>de</strong> constituire al asociatiei ( proprietari,locatari)Data .............................................. Semnatura .............................


Predat pentru solutie tehn .in data <strong>de</strong> ................................Semnatura....................Primit solutia tehnica in data <strong>de</strong> ........................................ Semnatura ...................SOLUTIA TEHNICA DE AMPLASAMENT ABRANSAMENTULUI DE APA / RACORDULUI DE CANALIntocmit <strong>de</strong> : Verificat <strong>de</strong> :Functia .................................. Functia ...................................Nume ...................................... Nume ......................................Prenume .................................. Prenume ....................................Semnatura ................................... Semnatura ...............................Data ............................................ Data ..........................................

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