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["要領様式第9号"]
["道路占用工期延長申請書"]
[]
[null,"吹　田　市　長　 宛",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,"年",null,"月",null,"日"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"〒"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"住所"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※","本人（法人その他の団体にあっては代表者）による\n自署又は記名押印してください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"担当者"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電話"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E-mail"]
[]
[null,"　先に許可（回答）のあった道路の占用について、下記のとおり工事の時期を延長したい"]
[null,"ので道路法第３２条第３項の規定により申請します。"]
[]
["占用の目的"]
["占用の場所",null,null,null,"路線名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"車道","・",null,"歩道","・",null,"その他"]
[null,null,null,null,"場所","吹田市"]
["従前の許可\n番号年月日",null,null,null,"令和",null,null,"年",null,"月",null,"日付け",null,null,null,null,null,null,null,"吹田市指令土道 第",null,null,null,null,null,null,null,null,"号"]
["延長の理由"]
[]
["従前の\n工事の時期",null,null,null,"令和",null,null,"年",null,"月",null,"日から",null,null,"日間","延長する\n工事の時期",null,null,null,"令和",null,null,"年",null,"月",null,"日から",null,null,"日間"]
[null,null,null,null,"令和",null,null,"年",null,"月",null,"日まで",null,null,null,null,null,null,null,"令和",null,null,"年",null,"月",null,"日まで"]
[]
["添付書類"]
[null,"備　　考"]
[]
[]
[]
[]
["申請書に関する連絡先担当（任意記入）"]
[null,"担当者"]
[null,"電話"]
[null,"E-mail"]
[]
[]
[]
[]
[null,null,null,"記 載 事 項"]
[]
["　１．",null,"申請人が法人である場合には、「住所」の欄には主たる事務所の所在地、「氏名」の欄には名称及び代表者の氏名を"]
[null,null,"従前の許可書又は回答書に記載されたとおり記載するとともに、「担当者」の欄に所属・氏名を記載してください。"]
["　２．",null,"「場所」の欄には、従前の許可書又は回答書に記載されたとおり地番まで記載してください。占用が２以上の地番に"]
[null,null,"わたる場合には、起点と終点を記載してください。"]
[null,null,"「車道・歩道・その他」については、該当するものを○で囲んでください。"]
["　３．",null,"「従前の許可番号年月日」の欄には、従前の許可書又は回答書の番号及び年月日を記載してください。"]
["　４．",null,"「延長の理由」の欄には、工事の時期を延長しなければならない理由を分かりやすく、明確に記載してください。"]
["　５．",null,"「従前の工事の時期」の欄には、従前の許可書又は回答書に記載されたとおり記載してください。"]
["　６．",null,"「延長する工事の時期」の欄には、従前の許可又は回答を受けた工事の時期の始期から延長しようとする終期までを"]
[null,null,"記載してください。"]
["　７．",null,"「添付書類」の欄には、道路占用の場所を明らかにした図面、従前の許可書又は回答書の写し等その他必要な書類を"]
[null,null,"添付した場合に、その書類名を記載してください。"]

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["○選択"]
[]
["○"]