Ctre

1

______________________ Agenia Regional de Protecie a Mediului

PROIECTANT Cluj

F I A T E H N I C

n vederea emiterii Acordului Unic,

pentru obinerea acordului de mediu

1. DATE DE IDENTIFICARE A OBIECTIVULUI DE INVESTIII

1. Denumire (1)____________________________________________________________

2. Amplasament(1)_________________________________________________________

3. Beneficiar(1)____________________________________________________________

4. Proiectant(1)______________elaborator (1)____________________________________

2. CARACTERISTICILE TEHNICE SPECIFICE ALE INVESTIIEI (1) (n

funcie de tipul de construcie i n conformitate cu anexele nr.1.1 i 1.2 din Ordinul

MAPM nr. 860/2002).

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. MODUL DE INDEPLINIRE A CERINELOR AVIZATORULUI (1):

Se va complecta cu lista actelor, planelor i documentaiilor depuse la dosar

conform punctului I-2 pagina 3

________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. MODUL DE INDEPLINIRE A CONDIIILOR I RESTRICIILOR IMPUSE

1.______________________________________________________________________2.______________________________________________________________________3.______________________________________________________________________4.______________________________________________________________________5.______________________________________________________________________6.______________________________________________________________________

INTOCMIT (2):

2

5. Vznd specificrile prezentate n FIA TEHNIC privind modul de

indeplinire 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 (3)________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(3)

___________________________________

(nume, prenumel, semntura)

L.S.

Data : _______________