도로점용허가 신청서 양식

<table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 197.71pt; height: 14.82pt;" colspan="5">[별지 제1호서식] <개정 2008.5.13></td><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 233.74pt; height: 14.82pt;" colspan="8">(앞쪽)</td></tr><tr><td valign="center" style="border-width: 1.98pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 359.58pt; height: 40.96pt;" rowspan="2" colspan="11">도로 등의 연결허가신청서</td><td valign="center" style="border-width: 1.98pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 71.87pt; height: 20.48pt;" colspan="2">처리기간</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 71.87pt; height: 20.48pt;" colspan="2">21일</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 42.95pt; height: 113.83pt;" rowspan="3">신청인</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 36.08pt;">①성 명</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 100.49pt; height: 36.08pt;" colspan="3">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 132.88pt; height: 36.08pt;" colspan="4">②주민등록번호(법인ㆍ사업자등록번호)</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 100.86pt; height: 36.08pt;" colspan="4">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 37.46pt;">③주 소</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 334.23pt; height: 37.46pt;" colspan="11">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 40.29pt;">④연락처</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 28.55pt; height: 40.29pt;">전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 80.43pt; height: 40.29pt;" colspan="3">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 27.29pt; height: 40.29pt;">휴대전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 91.44pt; height: 40.29pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 28.99pt; height: 40.29pt;" colspan="2">전자우편</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 77.53pt; height: 40.29pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 34.63pt;" colspan="4">⑤도로의 종류 및 노선명</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 260.15pt; height: 34.63pt;" colspan="9">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 34.63pt;" colspan="4">⑥연결시설 등의 종류 및 명칭</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 260.15pt; height: 34.63pt;" colspan="9">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 34.63pt;" colspan="4">⑦도로의 연결지점</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 260.15pt; height: 34.63pt;" colspan="9">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 34.63pt;" colspan="4">⑧사용목적</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 260.15pt; height: 34.63pt;" colspan="9">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt medium; border-style: solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 431.45pt; height: 206.83pt;" colspan="13"> 「도로법」 제64조제2항 및 「도로와 다른 도로 등과의 연결에 관한 규칙」 제4조에 따라 도로에 다른 도로ㆍ통로 그 밖의 시설을 연결하기 위하여 위와 같이 허가를 신청합니다.     년 월 일       신청인(시행자) (서명 또는 인)</td></tr><tr><td valign="center" style="border-width: medium medium medium 1.98pt; border-style: none none none solid; border-color: currentColor currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 20.48pt;" colspan="4">지방국토관리청장</td><td valign="center" style="border-width: medium 1.98pt 0.25pt medium; border-style: none solid solid none; border-color: currentColor rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 260.15pt; height: 40.96pt;" rowspan="2" colspan="9">귀하</td></tr><tr><td valign="center" style="border-width: medium medium 0.25pt 1.98pt; border-style: none none solid solid; border-color: currentColor currentColor rgb(0, 0, 0) rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 20.48pt;" colspan="4">국도관리사무소장</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt medium 1.98pt; border-style: solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 382.22pt; height: 45.34pt;" rowspan="2" colspan="12"> 구비서류 1. 연결계획서 1부</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 49.23pt; height: 20.48pt;">수수료</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 49.23pt; height: 24.86pt;">없음</td></tr><tr><td valign="center" style="border-width: medium 1.98pt 1.98pt; border-style: none solid solid; border-color: currentColor rgb(0, 0, 0) rgb(0, 0, 0); padding: 1.41pt; width: 431.45pt; height: 48.17pt;" colspan="13"> 2. 변속차로ㆍ부가차로ㆍ회전차로 및 부대시설 등의 설계도면 1부 3. 도로점용허가서 또는 도로점용허가신청서 1부</td></tr><tr><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 197.71pt; height: 39.68pt;" colspan="5">   </td><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 233.74pt; height: 39.68pt;" colspan="8">210mm×297mm(신문용지 54g/㎡(재활용품))</td></tr></tbody></table><table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 337.19pt; height: 17.66pt;" colspan="8">[별지 제21호서식]</td><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 113.21pt; height: 17.66pt;" colspan="3">(앞면)</td></tr><tr><td valign="center" style="border-width: 1.98pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 391.22pt; height: 57.96pt;" rowspan="2" colspan="9">   도로점용 허가신청서   ※ 뒷면의 신청안내와 작성방법을 읽고 적습니다.</td><td valign="center" style="border-width: 1.98pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 59.18pt; height: 28.98pt;" colspan="2">처리기간</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 59.18pt; height: 28.98pt;" colspan="2">뒷면참조</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 47.88pt; height: 121.65pt;" rowspan="3"><p class="0" style="text-align: center; line-height: 120%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">신청인</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 79.74pt; height: 58.03pt;"><p class="0" style="text-align: center; line-height: 120%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">① 성 명<p class="0" style="text-align: center; line-height: 120%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;"> (법인명)</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 93.53pt; height: 58.03pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 108.8pt; height: 58.03pt;" colspan="3">② 주민등록번호 (법인등록번호)</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 120.45pt; height: 58.03pt;" colspan="4">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 79.74pt; height: 31.81pt;">③ 주 소</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 138.41pt; height: 31.81pt;" colspan="4">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 63.92pt; height: 31.81pt;"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">전자우편</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 120.45pt; height: 31.81pt;" colspan="4">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 79.74pt; height: 31.81pt;">④ 연 락 처</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 34.08pt; height: 31.81pt;"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 104.33pt; height: 31.81pt;" colspan="3">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 63.92pt; height: 31.81pt;"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">휴대전화</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 120.45pt; height: 31.81pt;" colspan="4">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.62pt; height: 31.81pt;" colspan="2">⑤점용목적</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.78pt; height: 31.81pt;" colspan="9"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.62pt; height: 31.81pt;" colspan="2">⑥ 점용장소ㆍ면적</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.78pt; height: 31.81pt;" colspan="9"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.62pt; height: 31.81pt;" colspan="2">⑦점용기간</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 110.51pt; height: 31.81pt;" colspan="3"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 91.82pt; height: 31.81pt;" colspan="2">⑧굴착기간</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 120.45pt; height: 31.81pt;" colspan="4"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.62pt; height: 31.81pt;" colspan="2">⑨ 공작물(시설)구조</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.78pt; height: 31.81pt;" colspan="9"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.62pt; height: 31.81pt;" colspan="2">⑩ 공사실시방법</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.78pt; height: 31.81pt;" colspan="9"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.62pt; height: 31.81pt;" colspan="2">⑪공사시기</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.78pt; height: 31.81pt;" colspan="9"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.62pt; height: 31.81pt;" colspan="2">⑫ 도로복구방법</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.78pt; height: 31.81pt;" colspan="9"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.62pt; height: 33.26pt;" colspan="2">⑬ 도로종류 및 노선명</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.78pt; height: 33.26pt;" colspan="9"><p class="0" style="text-align: center; line-height: 130%; text-indent: -10.5pt; margin-left: 10.5pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 450.4pt; height: 107.5pt;" colspan="11"> 「도로법」 제38조 및 같은 법 시행령 제28조제1항에 따라 위와 같이 도로점용허가를 신청합니다.<p class="0" style="text-align: center; line-height: 130%; text-indent: -20pt; margin-right: 12pt; margin-left: 32pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;"> 년 월 일<p class="0" style="text-align: center; line-height: 130%; text-indent: -20pt; margin-right: 12pt; margin-left: 32pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">   <p class="0" style="text-align: right; line-height: 130%; text-indent: -20pt; margin-right: 12pt; margin-left: 32pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">신청인 (서명 또는 인) 도로관리청장 귀하</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt medium; border-style: solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 450.4pt; height: 74.2pt;" colspan="11"> ※ 구비서류 1. 설계도면 1부(점용장소의 면적은 1/1,200 이상의 평면도에 도로중심선에서의 좌우거리 및 위치를 표시함. 다만, 영 제28조제5항제6호ㆍ제7호 및 제9호의 경우에는 1/1,200이상의 평면도 1부) 2. 주요지하매설물관리자의 의견서 1부(도로의 굴착을 수반하는 경우만 첨부함) 3. 주요지하매설물의 사후관리계획 1부(신청인이 주요지하매설물의 관리자인 경우만 첨부함)</td></tr><tr><td valign="center" style="border-width: medium 0.25pt 1.98pt 1.98pt; border-style: none solid solid; border-color: currentColor rgb(0, 0, 0) rgb(0, 0, 0); padding: 1.41pt; width: 395pt; height: 47.57pt;" rowspan="2" colspan="10"> 4. 영 제34조에 따른 도로관리심의회의 심의ㆍ조정 결과를 반영한 안전대책 등에 관한 서류   </td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 55.4pt; height: 17.66pt;"><p class="0" style="text-align: center; line-height: 110%; text-indent: -6pt; margin-left: 6pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">⑭수수료</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 1.98pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 55.4pt; height: 29.91pt;"><p class="0" style="text-align: center; line-height: 110%; text-indent: -6pt; margin-left: 6pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">1,000원</td></tr><tr><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 221.15pt; height: 17.66pt;" colspan="4">   </td><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 229.25pt; height: 17.66pt;" colspan="7">210㎜×297㎜(일반용지 60g/㎡)</td></tr></tbody></table><table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 197.71pt; height: 2.82pt;" colspan="6">[별지 제3호서식] <신설 2008.5.13></td><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 250.72pt; height: 2.82pt;" colspan="5">(앞쪽)</td></tr><tr><td valign="center" style="border-width: 1.98pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 359.58pt; height: 40.96pt;" rowspan="2" colspan="9">도로 등의 연결허가 변경신청서</td><td valign="center" style="border-width: 1.98pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 88.85pt; height: 20.48pt;" colspan="2">처리기간</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 88.85pt; height: 20.48pt;" colspan="2">10일</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 42.95pt; height: 111pt;" rowspan="3">신청인</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 36.08pt;" colspan="2">①성 명(법인명)</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 100.49pt; height: 36.08pt;" colspan="3">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 132.88pt; height: 36.08pt;" colspan="2">②주민등록번호(법인ㆍ사업자등록번호)</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 117.84pt; height: 36.08pt;" colspan="3">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 37.46pt;" colspan="2">③주 소</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 351.21pt; height: 37.46pt;" colspan="8">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 37.46pt;" colspan="2">④연락처</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 42.7pt; height: 37.46pt;">전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 57.79pt; height: 37.46pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 52.76pt; height: 37.46pt;">휴대전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 80.12pt; height: 37.46pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 51.63pt; height: 37.46pt;" colspan="2">전자우편</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 66.21pt; height: 37.46pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑤허가번호</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑥도로의 종류 및 노선명</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑦연결시설 등의 종류 및 명칭</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑧도로의 연결지점</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑨사용목적</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑩변경내용</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt medium; border-style: solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 448.43pt; height: 226.41pt;" colspan="11"> 「도로법」 제64조제2항 및 「도로와 다른 도로 등과의 연결에 관한 규칙」 제4조제6항에 따라 도로와 다른 도로ㆍ통로 그 밖의 시설의 연결허가 변경을 신청합니다.     년 월 일     신청인(시행자) (서명 또는 인)</td></tr><tr><td valign="center" style="border-width: medium medium 0.25pt 1.98pt; border-style: none none solid solid; border-color: currentColor currentColor rgb(0, 0, 0) rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 40.96pt;" colspan="5">대전지방국토관리청장</td><td valign="center" style="border-width: medium 1.98pt 0.25pt medium; border-style: none solid solid none; border-color: currentColor rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 277.13pt; height: 40.96pt;" colspan="6">귀하</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt medium 1.98pt; border-style: solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 47.77pt; height: 23.31pt;" colspan="2">수수료</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 400.66pt; height: 23.31pt;" colspan="9">없 음</td></tr><tr><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 197.71pt; height: 5.64pt;" colspan="6">   </td><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 250.72pt; height: 5.64pt;" colspan="5">210mm×297mm(신문용지 54g/㎡(재활용품))</td></tr></tbody></table>   도로점용허가 가능여부 신청서     1. 신 청 인 가. 성 명 : 나. 주 소 : 다. 연락처 :   2. 노 선 명 : 국도 제( )호선   3. 점용목적 :   4. 사업부지 지번 :   5. 점용신청 지번 :   6. 주변현황(건물, 교량, 연결도로 등)     7. 기타(첨부서류)     년 월 일     신청인 : (서명, 인)     대전지방국토관리청장 귀하[별지 제25호서식]<table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: 1.7pt 1.7pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 449.16pt; height: 291.86pt;" colspan="6">   도로점용사업계획서   「도로법 시행령」 제30조제1항에 따라 도로점용에 관한 사업계획서를 다음과 같이 제출합니다.   년 월 일   제출자 주소 주민등록번호 성명 (서명 또는 인)   귀하</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 74.86pt; height: 36.43pt;">①도로의종류</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 74.86pt; height: 36.43pt;">②점용구분</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 74.86pt; height: 36.43pt;">③점용(공사)건명</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 74.86pt; height: 36.43pt;">④점용기간</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 74.86pt; height: 36.43pt;">⑤점용목적</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 74.86pt; height: 36.43pt;">⑥비고</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 74.86pt; height: 59.25pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 74.86pt; height: 59.25pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 74.86pt; height: 59.25pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 74.86pt; height: 59.25pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 74.86pt; height: 59.25pt;">   </td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 74.86pt; height: 59.25pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 449.16pt; height: 153.85pt;" colspan="6">   ※ 주 : 1) 점용구분란에는 영 별표2의 규정에 의한 점용료산정기준표의 구분에 따라 기입합니다. 2) 도로의 굴착을 수반하는 경우에는 굴착위치, 굴착기간, 시간, 공사구간, 교통소통대책, 먼지발생대책, 안전대책 등을 명시합니다.   </td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 449.16pt; height: 135.18pt;" colspan="6"> 구비서류 : 1. 교통소통대책 1부 2. 먼지발생대책 1부 3. 안전사고대책 1부 4. 도로시설유지대책 1부 5. 주요지하매설물에 대한 안전대책 1부(주요지하매설물이 있는 경우에 한한다)</td></tr></tbody></table><table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 450.4pt; height: 17.66pt;" colspan="14">[별지 제27호서식]</td></tr><tr><td valign="center" style="border-width: 1.98pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 392.63pt; height: 40.98pt;" rowspan="2" colspan="12">도로점용공사(원상회복공사) 완료확인 신청서</td><td valign="center" style="border-width: 1.98pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 57.77pt; height: 20.49pt;" colspan="2">처리기간</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 57.77pt; height: 20.49pt;" colspan="2">7일</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 42.58pt; height: 78.45pt;" rowspan="3">신청인</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 59.57pt; height: 26.15pt;">성명</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 111.28pt; height: 26.15pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 68.83pt; height: 26.15pt;" colspan="4">생년월일</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 168.14pt; height: 26.15pt;" colspan="6">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 59.57pt; height: 26.15pt;">주소</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 180.11pt; height: 26.15pt;" colspan="6">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 57.71pt; height: 26.15pt;" colspan="3">전자우편</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 110.43pt; height: 26.15pt;" colspan="3">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 59.57pt; height: 26.15pt;">연락처</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 58.04pt; height: 26.15pt;">전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 122.07pt; height: 26.15pt;" colspan="5">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 57.71pt; height: 26.15pt;" colspan="3">휴대전화</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 110.43pt; height: 26.15pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 102.15pt; height: 26.15pt;" colspan="2">도로의 종류</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 348.25pt; height: 26.15pt;" colspan="12">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 102.15pt; height: 26.15pt;" colspan="2">노선명</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 348.25pt; height: 26.15pt;" colspan="12">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 102.15pt; height: 26.15pt;" colspan="2">점용장소</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 114.11pt; height: 26.15pt;" colspan="3">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 74.16pt; height: 26.15pt;" colspan="4">점용면적</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 159.98pt; height: 26.15pt;" colspan="5">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 102.15pt; height: 45.35pt;" colspan="2">공작물 또는 시설물구조</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 348.25pt; height: 45.35pt;" colspan="12">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 102.15pt; height: 26.15pt;" colspan="2">허가연월일</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 142.73pt; height: 26.15pt;" colspan="5">년 월 일</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 73.84pt; height: 26.15pt;" colspan="3">준공연월일</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 131.68pt; height: 26.15pt;" colspan="4">년 월 일</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 102.15pt; height: 26.15pt;" colspan="2">공사내용</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 348.25pt; height: 26.15pt;" colspan="12">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 450.4pt; height: 5.66pt;" colspan="14">   「도로법」 제38조제3항 및 제43조제2항에 따라 위와 같이 도로 점용공사(원상회복공사)를 완료하였음을 확인하여 주시기 바랍니다.     년 월 일     <p class="0" style="text-align: right; line-height: 0%; text-indent: -6pt; margin-left: 6pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">신청인(시행자) (서명 또는 인)       대전지방국토관리청장 귀하   </td></tr><tr><td valign="center" style="border-width: 0.25pt medium 1.98pt 1.98pt; border-style: solid none solid solid; border-color: rgb(0, 0, 0) currentColor rgb(0, 0, 0) rgb(0, 0, 0); padding: 1.41pt; width: 395.46pt; height: 39.15pt;" rowspan="3" colspan="13"> 구비서류: 설계도면 1부</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 54.94pt; height: 17.66pt;">수수료</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 54.94pt; height: 5.66pt;">없음</td></tr><tr><td valign="center" style="border-width: medium 1.98pt 1.98pt medium; border-style: none solid solid none; border-color: currentColor rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 54.94pt; height: 15.83pt;">   </td></tr><tr><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 225.2pt; height: 34.03pt;" colspan="6">   </td><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 225.2pt; height: 34.03pt;" colspan="8">210㎜×297㎜(신문용지 54g/㎡)</td></tr></tbody></table><table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 478.7pt; height: 5.66pt;" colspan="12">[별지 제1호서식]</td></tr><tr><td valign="center" style="border-width: 1.98pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 423.3pt; height: 43.13pt;" rowspan="2" colspan="10">권리ㆍ의무의 승계신고서</td><td valign="center" style="border-width: 1.98pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 55.4pt; height: 21.66pt;" colspan="2">처리기간</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 55.4pt; height: 21.47pt;" colspan="2">2일</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 44.87pt; height: 95.43pt;" rowspan="3" colspan="2">승계인</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 72.84pt; height: 31.81pt;">① 성 명</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 90.52pt; height: 31.81pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 95.66pt; height: 31.81pt;" colspan="3">② 주민등록번호</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 174.81pt; height: 31.81pt;" colspan="4">-</td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 72.84pt; height: 31.81pt;">③ 주 소</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 176.27pt; height: 31.81pt;" colspan="4">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 51.13pt; height: 31.81pt;" colspan="2">전자우편</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 133.59pt; height: 31.81pt;" colspan="3">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 72.84pt; height: 31.81pt;">④ 연락처</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 31.07pt; height: 31.81pt;">전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 145.2pt; height: 31.81pt;" colspan="3">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 51.13pt; height: 31.81pt;" colspan="2">휴대전화</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 133.59pt; height: 31.81pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 117.71pt; height: 36.86pt;" colspan="3">⑤ 허가 번호</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 360.99pt; height: 36.86pt;" colspan="9">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 117.71pt; height: 36.86pt;" colspan="3">⑥권리ㆍ의무의 내용및취득근거</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 360.99pt; height: 36.86pt;" colspan="9">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 1.13pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 117.71pt; height: 34.64pt;" colspan="3">⑦승계사유</td><td valign="center" style="border-width: 0.25pt 1.98pt 1.13pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 360.99pt; height: 34.64pt;" colspan="9">   </td></tr><tr><td valign="center" style="border-width: 1.13pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 478.7pt; height: 166.21pt;" colspan="12">   「도로법」 제4조 및 같은 법 시행규칙 제2조에 따라 위와 같이 신고합니다. 년 월 일피승계인 (서명 또는 인)승계인 (서명 또는 인)   대전지방국토관리청장 귀하</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 1.98pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 2.83pt; width: 28.77pt; height: 252.36pt;" rowspan="5">구비서류</td><td valign="center" style="padding: 2.83pt; border: 0.25pt solid rgb(0, 0, 0); width: 201.4pt; height: 22.66pt;" colspan="5">신고인(대표자) 제출서류</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 2.83pt; width: 248.53pt; height: 22.66pt;" colspan="6"><p class="0" style="text-align: center; line-height: 130%; margin-right: 10pt; margin-left: 10pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">담당 공무원 확인사항</td></tr><tr><td valign="center" style="padding: 2.83pt; border: 0.25pt solid rgb(0, 0, 0); width: 201.4pt; height: 73.96pt;" rowspan="3" colspan="5">1. 권리ㆍ의무의 취득에 관한 허가관련 내역서2. 권리ㆍ의무의 양도에 관한 계약서(권리ㆍ의무의 양도인 경우에만 제출합니다)</td><td valign="center" style="border-width: 0.25pt 1.98pt medium 0.25pt; border-style: solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 2.83pt; width: 248.53pt; height: 30.98pt;" colspan="6">   1. 상속인의 가족관계등록부(상속의 경우만 해당하며, 담당 공무원의 확인에 동의하지 아니하는 경우 신고인이 직접 제출해야 합니다)2. 합병 후 존속하는 법인이나 합병에 의하여 </td></tr><tr><td valign="center" style="border-width: medium 0.25pt 0.25pt; border-style: none solid solid; border-color: currentColor rgb(0, 0, 0) rgb(0, 0, 0); padding: 2.83pt; width: 202.47pt; height: 42.98pt;" rowspan="2" colspan="5">설립되는 법인의 법인등기부등본 (법인의 합병인 경우만 해당합니다)   </td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 2.83pt; width: 46.06pt; height: 19.49pt;"><p class="0" style="text-align: center; line-height: 130%; text-indent: -7.8pt; margin-left: 7.8pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">수수료</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 2.83pt; width: 46.06pt; height: 23.49pt;"><p class="0" style="text-align: center; line-height: 130%; text-indent: -7.8pt; margin-left: 7.8pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0.0pt 0.0pt 0.0pt 0.0pt;">없 음</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 1.98pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 2.83pt; width: 449.93pt; height: 155.74pt;" colspan="11">   본인은 이 건 업무처리와 관련하여 「전자정부법」 제21조제1항에 따른 행정정보의 공동이용을 통하여 담당 공무원이 위의 담당 공무원 확인사항 제1호를 확인하는 것에 동의합니다.   신고인(대표자) (서명 또는 인)   </td></tr><tr><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 478.7pt; height: 5.66pt;" colspan="12">210㎜×297㎜(일반용지 60g/㎡)</td></tr></tbody></table>양도양수 계약서   □ 양도양수 사항 : 도로점용(연결)허가 허가번호(허가일) 제( )호( . . )     상기 허가에 따른 일체의 권리의무에 대하여 은(는) 에게 양도하며, 은(는) 이의없이 이를 양수함.   년 월 일     양 도 인 (피승계인) 성 명 : (인) 주민등록번호 : 주 소 : 연 락 처 :   양 수 인 (승 계 인) 성 명 : (인) 주민등록번호 : 주 소 : 연 락 처 :   붙임 양도인 및 양수인 인감증명서 각 1부.   대전지방국토관리청장 귀하<table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: 2.26pt 2.26pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 450.62pt; height: 69.42pt;" colspan="5">도로점용(연결)공사 준공기한 연장허가 신청서</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 93.52pt; height: 80.28pt;" rowspan="2">신 청 인</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 51.07pt; height: 39.31pt;">성 명</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 99.18pt; height: 39.31pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 79.37pt; height: 39.31pt;">주 민등 록 번 호</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.48pt; height: 39.31pt;">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 51.07pt; height: 40.97pt;">주 소</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 306.03pt; height: 40.97pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 93.52pt; height: 38.29pt;">도로의종류</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 150.25pt; height: 38.29pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 79.37pt; height: 38.29pt;">노 선 명</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.48pt; height: 38.29pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 93.52pt; height: 50.63pt;">허가연월일(허가번호)</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 150.25pt; height: 50.63pt;" colspan="2">   (허가번호 : 제 호)</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 79.37pt; height: 50.63pt;">준공예정연 월 일</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.48pt; height: 50.63pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 93.52pt; height: 41.12pt;">점용(연결)장소</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 357.1pt; height: 41.12pt;" colspan="4">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 93.52pt; height: 41.12pt;">점용(연결)면적</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 150.25pt; height: 41.12pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 79.37pt; height: 41.12pt;">점용(연결)목 적</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.48pt; height: 41.12pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 93.52pt; height: 82.41pt;" rowspan="2">준 공 기 한 </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 51.07pt; height: 41.12pt;">당 초</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 306.03pt; height: 41.12pt;" colspan="3">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 51.07pt; height: 41.29pt;">변 경</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 306.03pt; height: 41.29pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 93.52pt; height: 87.42pt;">연 장 사 유</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 357.1pt; height: 87.42pt;" colspan="4">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 2.26pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 450.62pt; height: 24.31pt;" colspan="5">   위와 같이 도로점용(연결)공사 준공기한 연장허가를 신청합니다.     년 월 일     신청인(피허가자) (서명 또는 인)     연락처     대전지방국토관리청장 귀하     </td></tr></tbody></table><table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 197.71pt; height: 2.82pt;" colspan="6">[별지 제2호서식] <신설 2008.5.13></td><td valign="center" style="border-width: medium medium 1.98pt; border-style: none none solid; border-color: currentColor currentColor rgb(0, 0, 0); padding: 1.41pt; width: 250.72pt; height: 2.82pt;" colspan="5">(앞쪽)</td></tr><tr><td valign="center" style="border-width: 1.98pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 359.58pt; height: 40.96pt;" rowspan="2" colspan="9">도로 등의 연결허가기간 연장신청서</td><td valign="center" style="border-width: 1.98pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 88.85pt; height: 20.48pt;" colspan="2">처리기간</td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 88.85pt; height: 20.48pt;" colspan="2">5일</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 42.95pt; height: 99.68pt;" rowspan="3">신청인</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 2.82pt;" colspan="2">①성 명(법인명)</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 100.49pt; height: 2.82pt;" colspan="3">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 132.88pt; height: 2.82pt;" colspan="2">②주민등록번호(법인ㆍ사업자등록번호)</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 117.84pt; height: 2.82pt;" colspan="3">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 34.63pt;" colspan="2">③주 소</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 351.21pt; height: 34.63pt;" colspan="8">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 54.27pt; height: 62.23pt;" colspan="2">④연락처</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 31.38pt; height: 62.23pt;">전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 69.11pt; height: 62.23pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 52.76pt; height: 62.23pt;">휴대전화</td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 80.12pt; height: 62.23pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.25pt solid rgb(0, 0, 0); width: 51.63pt; height: 62.23pt;" colspan="2">전자우편</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 66.21pt; height: 62.23pt;">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑤허가번호</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑥도로의 종류 및 노선명</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑦연결시설 등의 종류 및 명칭</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑧도로의 연결지점</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑨사용목적</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt 0.25pt 1.98pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 28.97pt;" colspan="5">⑩연장사유</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 277.13pt; height: 28.97pt;" colspan="6">   </td></tr><tr><td valign="center" style="border-width: 0.25pt 1.98pt medium; border-style: solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 448.43pt; height: 263.2pt;" colspan="11"> 「도로법」 제64조제2항 및 「도로와 다른 도로 등과의 연결에 관한 규칙」 제4조제6항에 따라 도로와 다른 도로ㆍ통로 그 밖의 시설의 연결허가기간 연장을 신청합니다.       년 월 일         신청인(시행자) (서명 또는 인)</td></tr><tr><td valign="center" style="border-width: medium medium 0.25pt 1.98pt; border-style: none none solid solid; border-color: currentColor currentColor rgb(0, 0, 0) rgb(0, 0, 0); padding: 1.41pt; width: 171.3pt; height: 40.96pt;" colspan="5">대전지방국토관리청장</td><td valign="center" style="border-width: medium 1.98pt 0.25pt medium; border-style: none solid solid none; border-color: currentColor rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 277.13pt; height: 40.96pt;" colspan="6">귀하</td></tr><tr><td valign="center" style="border-width: 0.25pt 0.25pt medium 1.98pt; border-style: solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 47.77pt; height: 23.31pt;" colspan="2">수수료</td><td valign="center" style="border-width: 0.25pt 1.98pt 0.25pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 400.66pt; height: 23.31pt;" colspan="9">없 음</td></tr><tr><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 197.71pt; height: 5.64pt;" colspan="6">   </td><td valign="center" style="border-width: 1.98pt medium medium; border-style: solid none none; border-color: rgb(0, 0, 0) currentColor currentColor; padding: 1.41pt; width: 250.72pt; height: 5.64pt;" colspan="5">210mm×297mm(신문용지 54g/㎡(재활용품))</td></tr></tbody></table><table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: 2.26pt 2.26pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 447.79pt; height: 72.25pt;" colspan="5">도로점용(연결)허가 기간연장 허가신청서</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 99.18pt; height: 40.66pt;">주 소</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 348.61pt; height: 40.66pt;" colspan="4">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 99.18pt; height: 38.29pt;">주민등록번호</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 147.42pt; height: 38.29pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 73.71pt; height: 38.29pt;">성 명</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.48pt; height: 38.29pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 99.18pt; height: 38.29pt;">도로의 종류</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 147.42pt; height: 38.29pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 73.71pt; height: 38.29pt;">노 선 명</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.48pt; height: 38.29pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 99.18pt; height: 50.63pt;">허가연월일(허가번호)</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 147.42pt; height: 50.63pt;" colspan="2">   (허가번호 : 제 호)</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 73.71pt; height: 50.63pt;">연 락 처</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.48pt; height: 50.63pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 99.18pt; height: 41.12pt;">점용(연결)장소</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 348.61pt; height: 41.12pt;" colspan="4">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 99.18pt; height: 41.12pt;">점용(연결)면적</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 147.42pt; height: 41.12pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 73.71pt; height: 41.12pt;">점용(연결)목 적</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 127.48pt; height: 41.12pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 99.18pt; height: 82.41pt;" rowspan="2">점용(연결)허가기간</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 45.41pt; height: 41.12pt;">당 초</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 303.2pt; height: 41.12pt;" colspan="3">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 45.41pt; height: 41.29pt;">변 경</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 303.2pt; height: 41.29pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 99.18pt; height: 87.42pt;">연 장 사 유</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 348.61pt; height: 87.42pt;" colspan="4">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 2.26pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 447.79pt; height: 24.31pt;" colspan="5">     위와 같이 도로점용(연결) 기간연장허가를 신청합니다.     년 월 일     신청인(피허가자) (서명 또는 인)       대전지방국토관리청장 귀하     </td></tr></tbody></table><table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="padding: 1.41pt; border: 2.26pt solid rgb(0, 0, 0); width: 450.79pt; height: 2.82pt;">   도로점용(연결)공사 착수신고서   1. 도로의 종류 : 일반국도   2. 노 선 명 : 제 호선   3. 공사의 종류 :   4. 점용(연결)목적 :   5. 점용(연결)장소 :   6. 허 가 번 호 :   7. 허가년월일 : 년 월 일   8. 착수년월일 : 년 월 일   9. 준 공 기 한 : 년 월 일     위와 같이 도로점용(연결) 공사를 착수하였음을 신고합니다.   년 월 일   주 소 : 성 명(피허가자) : (서명 또는 인) 연락처 :   대전지방국토관리청장 귀하     </td></tr></tbody></table> 도로점용(연결)허가 취소 신청서     ㅇ 허가번호(허가일) : 제 호( . . .)<table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: 2.26pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 103.17pt; height: 39.46pt;">주 소</td><td valign="center" style="border-width: 2.26pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 343.47pt; height: 39.46pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 103.17pt; height: 39.46pt;">주민등록번호</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 114.49pt; height: 39.46pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 103.17pt; height: 39.46pt;">성 명</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 125.81pt; height: 39.46pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 103.17pt; height: 39.46pt;">도로의 종류</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 114.49pt; height: 39.46pt;">일반국도</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 103.17pt; height: 39.46pt;">노 선 명</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 125.81pt; height: 39.46pt;">제 호선</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 103.17pt; height: 39.46pt;">점용(연결)장소</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 343.47pt; height: 39.46pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 103.17pt; height: 39.46pt;">점용(연결)면적</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 114.49pt; height: 39.46pt;"> ㎡</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 103.17pt; height: 39.46pt;">점용(연결)목적</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 125.81pt; height: 39.46pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 103.17pt; height: 42.29pt;">점용(연결)기간</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 343.47pt; height: 42.29pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 103.17pt; height: 45.12pt;">사 유</td><td valign="center" style="border-width: 0.28pt 2.26pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 343.47pt; height: 45.12pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 2.26pt 2.26pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 446.64pt; height: 2.82pt;" colspan="4">   붙임 : 관련증빙서류 1부   상기와 같이 도로점용(연결)허가를 취소하고자 신청합니다.   년 월 일     신청인(피허가자) : (인) 연락처 :   대전지방국토관리청장 귀하     </td></tr></tbody></table>[별지 제15호서식]<table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: 1.7pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 377.13pt; height: 60.43pt;" rowspan="2" colspan="8">공사시행허가신청서</td><td valign="center" style="border-width: 1.7pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 68.9pt; height: 28.68pt;">처리기간</td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 68.9pt; height: 31.75pt;">15일</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 35.07pt; height: 84.44pt;" rowspan="2">신청인</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 88.98pt; height: 42.82pt;">성 명</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 117.85pt; height: 42.82pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 94.76pt; height: 42.82pt;">주민등록번호</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 109.37pt; height: 42.82pt;" colspan="4">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 88.98pt; height: 41.62pt;">주 소</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 321.98pt; height: 41.62pt;" colspan="7">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 124.05pt; height: 42.3pt;" colspan="2">도로의종류(노선명)</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 321.98pt; height: 42.3pt;" colspan="7">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 124.05pt; height: 42.3pt;" colspan="2">공사의 종류</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 321.98pt; height: 42.3pt;" colspan="7">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 124.05pt; height: 42.3pt;" colspan="2">공사구간</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 321.98pt; height: 42.3pt;" colspan="7"> 부터 까지 ( ㎞)</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 124.05pt; height: 42.3pt;" colspan="2">공사장소</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 321.98pt; height: 42.3pt;" colspan="7">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 124.05pt; height: 42.3pt;" colspan="2">착수예정일 </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 116.85pt; height: 42.3pt;">년 월 일</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 99.21pt; height: 42.3pt;" colspan="4">준공예정일</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 105.92pt; height: 42.3pt;" colspan="2">년 월 일</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 124.05pt; height: 41.85pt;" colspan="2">공사사유</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 321.98pt; height: 41.85pt;" colspan="7">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 446.03pt; height: 205.24pt;" colspan="9"> 도로법 제34조 및 같은 법 시행령 제23조제1항에 따라 위와 같이 도로에 관한 공사의 허가를 신청합니다.       년 월 일   신 청 인 (서명 또는 인)</td></tr><tr><td valign="center" style="border-width: 0.28pt medium 1.7pt 1.7pt; border-style: solid none solid solid; border-color: rgb(0, 0, 0) currentColor rgb(0, 0, 0) rgb(0, 0, 0); padding: 1.41pt; width: 339.11pt; height: 70.09pt;" rowspan="3" colspan="6"> 구비서류 : 사업계획서 및 설계도 각 1부</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 106.92pt; height: 23.29pt;" colspan="3">수수료</td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.25pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 106.92pt; height: 23.29pt;" colspan="3">공사비의 1/1,000</td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt 1.7pt medium; border-style: solid solid solid none; border-color: rgb(0, 0, 0) rgb(0, 0, 0) rgb(0, 0, 0) currentColor; padding: 1.41pt; width: 106.92pt; height: 23.51pt;" colspan="3">   </td></tr></tbody></table>[별지 제17호서식]<table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="padding: 1.41pt; border: 2.26pt solid rgb(0, 0, 0); width: 450.79pt; height: 674.36pt;">도로공사 착수신고서     1. 도로의 종류 :   2. 노 선 명 :   3. 공사의 종류 :   4. 구 간 :   5. 허가년월일 :   6. 착수년월일 :   7. 준공예정연월일 :     「도로법 시행령」 제23조제4항에 따라 위와 같이 도로공사를 착수하였음을 신고합니다.     년 월 일   공사시행자 : (서명 또는 인)   도로관리청 귀하</td></tr></tbody></table>[별지 제18호서식]<table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: 1.7pt 1.7pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 451.97pt; height: 110.91pt;" colspan="4">도로공사 준공검사 신청서   귀하</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 129.71pt; height: 45.13pt;">도로의 종류</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 110.25pt; height: 45.13pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 101.76pt; height: 45.13pt;">노 선 명</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 110.25pt; height: 45.13pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 129.71pt; height: 45.13pt;">도로공사허가연월일</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.26pt; height: 45.13pt;" colspan="3">년 월 일</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 129.71pt; height: 45.13pt;">공사의 종류</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.26pt; height: 45.13pt;" colspan="3"> </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 129.71pt; height: 45.13pt;">공사의 구간</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.26pt; height: 45.13pt;" colspan="3"> 부터 까지 ( ㎞)</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 129.71pt; height: 45.13pt;">공사시행장소</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 322.26pt; height: 45.13pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 129.71pt; height: 44.68pt;">착수연월일</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 110.25pt; height: 44.68pt;">년 월 일</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 101.76pt; height: 44.68pt;">준공년월일</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 110.25pt; height: 44.68pt;">년 월 일</td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 451.97pt; height: 230.71pt;" colspan="4"> 「도로법 시행령」 제23조제4항에 따라 위와 같이 도로공사를 완료하였으므로 준공검사를 신청합니다.       년 월 일   공사시행자 (서명 또는 인)</td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 451.97pt; height: 55.94pt;" colspan="4"> 첨부서류 : 준공조서, 설계도 및 비용정산서 각 1부</td></tr></tbody></table><table style="border: 0.28pt solid rgb(0, 0, 0); border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="center" style="border-width: 1.7pt 1.7pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 449.14pt; height: 60pt;" colspan="5">비관리청공사 준공기한 연장허가 신청서</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 95.75pt; height: 85.92pt;" rowspan="2">신 청 인(피허자자)</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 50.28pt; height: 42.96pt;">성 명</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 97pt; height: 42.96pt;">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 89.23pt; height: 42.96pt;">주민등록번호</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 116.88pt; height: 42.96pt;">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 50.28pt; height: 42.96pt;">주 소</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 303.11pt; height: 42.96pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 95.75pt; height: 40.12pt;">도로의 종류</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 147.28pt; height: 40.12pt;" colspan="2">   </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 89.23pt; height: 40.12pt;">노 선 명</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 116.88pt; height: 40.12pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 95.75pt; height: 45.12pt;">허가연월일(허가번호)</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 147.28pt; height: 45.12pt;" colspan="2">   (허가번호 : )</td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 89.23pt; height: 45.12pt;">준공예정연월일</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 116.88pt; height: 45.12pt;">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 95.75pt; height: 40.12pt;">공 사 구 간</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 353.39pt; height: 40.12pt;" colspan="4"> 부터 까지 ( ㎞)</td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 95.75pt; height: 40.12pt;">공 사 장 소</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 353.39pt; height: 40.12pt;" colspan="4">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 95.75pt; height: 80.24pt;" rowspan="2">준 공 기 한 </td><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 50.28pt; height: 40.12pt;">당초</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 303.11pt; height: 40.12pt;" colspan="3">   </td></tr><tr><td valign="center" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 50.28pt; height: 40.12pt;">변경</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 303.11pt; height: 40.12pt;" colspan="3">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 95.75pt; height: 85.85pt;">연 장 사 유</td><td valign="center" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 353.39pt; height: 85.85pt;" colspan="4">   </td></tr><tr><td valign="center" style="border-width: 0.28pt 1.7pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 449.14pt; height: 218.95pt;" colspan="5">   위와 같이 비관리청 도로공사 준공기한의 연장허가를 신청합니다. 년 월 일   신청인(피허가자) (인) 연락처   대전지방국토관리청장 귀하   </td></tr></tbody></table>