Dubai Municipality - Form

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‫‪Organization Unit:‬‬ ‫إدارة اﻟﻤﺒﺎﻧﻲ‬ ‫اﻟﻮﺣﺪة اﻟﺘﻨﻈﯿﻤﯿﺔ‪:‬‬

‫‪Form sheet‬‬
‫ﻧﻤﻮذج طﻠﺐ ﻣﺨﻄﻄﺎت اﻟﻜﺘﺮوﻧﯿﺎ‬ ‫اﺳﻢ اﻟﻨﻤﻮذج ‪:‬‬
‫‪title:‬‬
‫‪Doc Ref.‬‬ ‫‪DM- BLD-P3-F1‬‬ ‫رﻗﻢ اﻟﻨﻤﻮذج ‪:‬‬

‫‪20‬‬ ‫‪/‬‬ ‫‪/‬‬ ‫اﻟﺘـﺎرﯾﺦ ‪:‬‬

‫اﻟﻤﺤﺘﺮم‬ ‫اﻟﺴــﯿﺪ ‪ /‬رﺋﯿﺲ ﻗﺴﻢ ﺗﺮاﺧﯿﺺ اﻟﺒﻨﺎء‬


‫ﺗﺤﯿﺔ طﯿﺒﺔ وﺑﻌﺪ‬
‫‪‬ﻧﺴﺨﺔ ﻣﻦ اﻟﻤﺨﻄﻄﺎت ﻋﻠﻰ ﻗﺮص ﻣﺪﻣﺞ‬ ‫اﻟﻤﻮﺿﻮع ‪:‬‬

‫رﻗﻢ اﻷرض ‪:‬‬


‫اﻟﺮﻗﻢ اﻟﻤﻤﯿﺰ ‪:‬‬
‫اﺳﻢ اﻟﻤﻨﻄﻘﺔ ‪:‬‬
‫ﯾﺮﺟﻰ اﻟﻤﻮاﻓﻘﺔ ﻋﻠﻰ ﺗﺰوﯾﺪﻧﺎ ﺑﻨﺴﺨﺔ ﻣﻦ اﻟﻤﺨﻄﻄﺎت اﻟﻤﻌﺘﻤﺪة ﻟﺪﯾﻜﻢ ﻋﻠﻰ اﻷرض اﻟﻤﺬﻛﻮرة أﻋﻼه ‪.‬‬

‫اﻟﻤــــﺎﻟﻚ ‪:‬‬

‫‪✓:‬‬ ‫اﻟﺘــﻮﻗﯿﻊ‬

‫ﻣﻘﺪم اﻟﻄﻠﺐ ‪:‬‬

‫اﻟﺘـــﻮﻗﯿﻊ ‪:‬‬

‫اﻟﻮﺛﺎﺋﻖ اﻟﻤﻄﻠﻮﺑﺔ ‪:‬‬


‫‪ -‬ﺻﻮرة ﺧﺮﯾﻄﺔ اﻟﺘﺨﻄﯿﻂ‬
‫‪ -‬ﺻﻮرة ﺟﻮاز اﻟﺴﻔﺮ)ﻟﻠﻤﺎﻟﻚ(‬
‫‪ -‬ﺗﻘﺪﯾﻢ اﻟﻤﺨﻄﻄﺎت اﻟﻜﺘﺮوﻧﯿﺎ‬

‫ﺗﺎرﯾﺦ اﻹﺻدار‪5/3/2007 :‬‬ ‫رﻗم اﻹﺻدار ‪1 :‬‬

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