CNI - Compania Nationala de Investitii



ANTET U.A.T.SOLICITAREPrivind includerea ?n Programul Na?ional de Construc?ii de Interes Public sau Social, Subprogramul "................................................."pentru obiectivul de investi?ii................................................................................................................DATE PRIVIND SOLICITANTULAutoritatea administra?iei publice care solicit? finan?area: .........................................................Reprezentant legalNume ?i prenume: ........................Func?ia: ........................................Persoana de contact:Nume ?i prenume: ........................Func?ia:......................................Telefon: ........................................e-mail: .....................................DATE GENERALE ALE INVESTI?IEIDenumirea obiectivului de investi?ii:...........................................................................................................................................................................................................................................................................................................Amplasamentul (ora?/comuna, sat, strada, num?rul, jude?)...........................................................................................Identificat potrivit C?r?ii funciare nr. ............... ?i num?r cadastral .............., ata?at? solicit?rii, suprafa?a de teren pe care beneficiarul are posibilitatea sa o predea ?n vederea realiz?rii construc?iei .........................................Titularul investi?iei..................................................Beneficiarul Investi?iei..................................................Statutul juridic al amplasamentului (imobil constituit din teren ?i/sau constructie): .........................................................................................................................................................................................................................................................................................................................................................................................................................................Fotografii ale amplasamentuluiDESCRIEREA INVESTI?IEI.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................Necesitatea promov?rii investi?iei.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................Oportunitatea investi?iei.....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................Certific prin semn?tura mea corectitudinea datelor completate ?n aceast? solicitare ?i declar, sub sanc?iunile stipulate de Codul Penal faptei de fals ?n acte publice, c? pentru obiectivul de investi?ie solicitat, nu beneficiem de finan?are din alte surse, respectiv:Fondul de interven?ie la dispozi?ia Guvernului, pentru unele unit??i administrativ-teritoriale afectate de calamit??i naturaleAlte programe/surse de finan?areLoc SEMNATURA ?i STAMPIL? ................
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