________________________ MINISTERUL SANATATII (proiectant) DIRECTIA DE SANATATE PUBLICA

FISA TEHNICA in vederea emiterii Acordului Unic. pentru obtinerea AVIZULUI SANITAR, 1. DATE DE IDENTIFICARE A OBIECTIVULUI DE INVESTITII 1. - Denumire(*1)____ _______________________________________________________ 2. - Amplasament(*1) ________________________________________________________ 3. - Beneficiar (*1) __________________________________________________________ 4. - Proiect nr. (*1)________________elaborator(*1)_______________________________ __________________________________________________________________________ 2. CARACTERISTICILE TEHNICE SPECIFICE ALE INVESTITIEI (*1) (in functie de tipul de constructie) ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ 3. MODUL DE INDEPLINIRE A CERINTELOR AVIZATORULUI (*1) ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ __________________________________________________________________ 4. MODUL DE INDEPLINIRE A CONDITIILOR SI RESTRICTIILOR IMPUSE (*1) ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ INTOCMIT(*2) 5. Vazand specificarile prezentate in FISA TEHNICA privind modul de indeplinire a cerintelor de avizare, precum si documentatia depusa pentru autorizare (PAC/PAD/POE), documentatia se acorda: AVIZ FAVORABIL in vederea emiterii Acordului unic fara/cu urmatoarele conditii (*3) ___________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ *) ___________________________ (nume, prenume, semnatura) L.S.

Data: __________ PRECIZARI PRIVIND COMPLETAREA FORMULARULUI "FISA TEHNICA" pentru obtinerea AVIZULUI SANITAR, I. DATE GENERALE**) 1. Baza legala - Legea nr.114/1996 republicata, a locuintei; - Legea 507/2002 respectiv 300/2004 privind autorizarea persoanelor fizice si asociatiilor familiale care desfasoara activitati economice in mod independent. - Ordin al ministrului sanatatii nr. 117/2002 privind aprobarea Procedurilor de reglementare sanitara pentru proiectele de amplasare, constructie, amenajare si reglementare sanitara a obiectivelor si a activitatilor desfasurate in acestea astfel decat cele supuse inregistrarii in registrul comertului. 2. CONTINUTUL DOCUMENTATIILOR - certificatul de urbanism (copie) - titlul asupra imobilului (copie) - plan de situatie si de incadrare in zona (anexa la certificatul de urbanism) - memoriu tehnic conform Ord. MS 117/2002 - schite sau planuri intocmite conf. Ord. MS 117/2002

- dovada de achitare a tarifului de avizare; - aviz apa canal (sau aviz S.G.A. dupa caz)

- dosar incopciat Dupa caz: - studiu de impact asupra sanatatii populatiei - certificat de inmatriculare - Actul constitutiv al societatii / unitatii 3. DURATA DE EMITERE A AVIZULUI - se calculeaza la 15 zile calendaristice de la data depunerii documentatiei complete. II. CONDITII SI RESTRICTII SPECIFICE INVESTITIEI IMPUSE DE AVIZATOR(*1) (caracteristicile tehnice care trebuie asigurate prin proiect)__________________________________ ___________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ III. INDICATII PRIVIND TAXA DE AVIZARE a) - Temei: **)- Conform Ordinului ministrului sanatatii nr. 364/2002 b) - Valoarea taxei: - Constructie = 50 lei (RON) - Amenajare = 50 lei (RON) c) - Modalitati de plata: la careria DSPJ Brasov din str. Al.Ioan Cuza nr.20 - Ordin de plata - Trezoreria Brasov - cont RO42TREZ1315032XXX000259 IV. ALTE DATE FURNIZATE DE AVIZATOR*) ___________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ NOTA: PRIVIND COMPLETAREA FORMULARULUI "FISA TEHNICA" (*1) De catre proiectant - cu datele rezultate din documentatie conform cerintelor avizatorului. (*2) De catre proiectant - cu numele, prenumele si titlul profesional al acestuia (cu drept de semnatura, abilitat / autorizat in domeniu, potrivit prevederilor legale). (*3) De catre avizator, ca urmare a analizei documentatiei si fisei depuse.

( *) De catre avizator, la faza de definitivare a formularului "FISA TEHNICA".

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