PRIMĂRIA MUNICIPIULUI BUCUREŞTI - PMB

[Pages:3]PRIMRIA MUNICIPIULUI BUCURETI

Direcia de Mediu

FI DE ?NREGISTRARE privind solicitarea Avizului de Defriare/Toaletare/Reduceri i regenerri coronament/Transplantare i Inventariere material dendrologic (faza PUD/PUZ/APMB) A. Solicitant: Nume: _______________________________Prenume:__________________________________

Adresa:_________________________________________________________sector__________

Telefon: _____________Fax: ___________ E-mail: _____________________________________

Act Identitate: Seria: ___Nr.:______________Eliberat:___________________________________

B. Solicit Aviz ?n nume(le):

Propriu: Altei Persoane

Institutiei

Necesit procur/ ?mputernicire

?n calitate de: _______________________________________________________________________________________ Nume: _______________________________ Prenume: _______________________________________ Adresa: ___________________________________________________________________sector________

Telefon: _____________ Fax: ___________ E-mail: _________________________________________

Act Identitate: Seria: _______ Nr.: _________ Eliberat: ________________________________________

C. Lucrarea vizeaz:

Domeniul Public: Parc Scuar Baze de productie Cimitire Loc de joaca Aliniament stradal Adiacent locuin La limit

Alte zone___________________

Proprietate Privat:

Teren propriu Limit proprietate Alt proprietate Alt situaie _____ __________________ __________________ __________________ __________________ __________________

Bd. Regina Elisabeta nr. 47, cod potal 050013, sector 5, Bucureti, Rom?nia

Tel: 021.305.55.00/

FPS-2.1.4.4-02/2

D. Localizare vegetaie / lucrare supus avizrii :

Adresa i alte elemente (poziionare arbori) :___________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ foto mat.dendrologic ______________________________________________________________________

E. Ce se solicit:

Defriare:

Arbori :

numr _________ Toaletare

Corecie

Arbuti

numr _________

Echilibrare

Gard viu

m.l. _________

Reducere

Altele: ____________________________________________________________

___________________________________________________________

Extragere rdcini Rzuire rdacini de suprafa Transplantare Protejare Aviz definitiv

Toaletare:

Ramuri arpante

Declarare: Arbori ocrotii numr _____ Arbuti ocrotii numr _____

F. Motivaie:

Viabil Lucrri edilitare

Uscat: ______ % Construcii Eliberare loc veci

Declin biologic Acces ?n:

imobil curte garaj

Pericol:

?nclinat Scorburos Rdcini afectate Rdcini care afecteaz

Altele: _________________________ _________________________________

Prejudicii:

Reele Construcii Anexe Gard Acoperi Trotuar Lucrri funerare

G. Documentaie Construcie / Reele Edilitare

Exist: Acord:

Vecini Asociaii proprietari/ locatari (tampil) Comisii O.C.P.I.Bucureti Proprietar sau administrator legal teren

Direcia pentru Agricultur a Municipiului Bucureti Act de Reglementare emis de Agenia pentru Protecia Mediului Bucureti Avizul/acordul Ministerului Culturii i Identitii Naionale pentru materialul dendrologic situat ?n zone protejate

Bd. Regina Elisabeta nr. 47, cod potal 050013, sector 5, Bucureti, Rom?nia

Tel: 021.305.55.00

FPS-2.1.4.4-02/2

Academia Rom?n Act v?nzare-cumprare Expertiz tehnic C.U. A.C. P. U. D. P. U. Z.

H. C. G. M. B. H.C.L.S.1-6 ...

Altele: _____________________

Extras de Carte Funciar

Titlu de proprietate

Hotar?re Judectoreasc

Act concesiune

Plan 1:500

Plan 1:2000

Protocol plantare/refacere/amenajare sp.verzi cu ADP 1-6

sau ALPAB

Plan Coordonare Reele

Plan de plantare compensare / amenajri sp.verzi /?ntocmit

i tampilat de arhitect peisagist

H. OBSERVAII _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

I. CORESPONDEN petent ? Direcia de Mediu prin: (vizit teren, acte suplimentare)

Format h?rtie/pot Telefonic Email

J. COMPLETAT solicitant

Nume i prenume __________________________________

(Semntura)

_______________________________

Pentru sugestii/ reclamaii privind ?ntreinerea spaiilor verzi, proiecte de mediu, accesai:

Bd. Regina Elisabeta nr. 47, cod potal 050013, sector 5, Bucureti, Rom?nia

Tel: 021.305.55.00

FPS-2.1.4.4-02/2

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