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[null,null,null,null,null,null,null,null,null,null,null,"給　水　装　置\n排　水　設　備",null,null,null,null,null,null,null,null,null,"新設等承認申請書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"用　紙・・・A4（紙厚６４ｇ/㎡　０．０９ｍｍ）\n             上質・中性紙、白色度８０％以上"]
[]
[null,null,null,"捨印"]
[]
[]
[]
[]
[]
[]
[]
["苫小牧市水道事業"]
[]
[]
["苫　小　牧　市　長　　様",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区　分"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"⓪"]
[]
[]
[]
["受付番号",null,null,null,null,null,"調定番号",null,null,null,null,null,null,"調定年月日",null,null,null,null,null,null,"水道窓口課受付番号",null,null,null,null,null,null,"②",null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号",null,"メーター\n口　径",null,null,"④",null,"m/m","④",null,"m/m","排水戸数"]
[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,"③",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メーター\n個　数",null,null,null,null,"個",null,null,"個",null,null,null,null,"このシートでは、申請書の作成方法をまとめています。"]
[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,null,null,null,"第",null,null,null,null,null,null,null,"号",null,"給　水\n戸　数",null,null,null,null,null,null,null,"戸",null,null,"戸",null,"隣の「入力シート」に情報を入力すると、"]
["　手数料及び水道利用加入金については、苫小牧市水道事業給水条例を契約の内容とすることに合意し、同条例第5条及び第32条の規定に基づき、次のとおり申請いたします。",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,"工　　事　　種　　別",null,null,null,null,null,null,null,null,null,null,null,"給　水",null,null,null,null,"⑤",null,null,null,null,"排　水",null,null,null,"⑤",null,null,null,null,"「提出用シート①②」に複写されます。"]
[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,"業　　態　　種　　別",null,null,null,null,null,null,null,null,null,null,null,"⑥",null,null,null,null,"検　針　方　式",null,null,null,null,null,null,"⑦"]
[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,"給　　水　　方　　式",null,null,null,null,null,null,null,null,null,null,null,"⑧",null,null,null,null,{"$f":"IF(AN25=\"受水槽\",\"有効容量\",\"\")","v":""},null,null,null,null,null,null,null,null,{"$f":"IF(AN25=\"受水槽\",\"㎥\",\"\")","v":""}]
["建築確認番号",null,null,null,null,null,"第",null,null,null,null,null,null,"号",null,"家屋種別",null,null,null,null,"①",null,null,null,null,null,null,"汚　水　公　設　桝",null,null,null,null,null,null,null,null,null,null,null,"⑨",null,null,null,null,"汚水取付管",null,null,null,null,null,null,"⑨"]
["設　置　場　所",null,null,null,null,null,"苫小牧市",null,null,null,null,null,null,null,"町",null,null,null,"丁目",null,null,null,"番",null,null,"号",null,"雨　水　公　設　桝",null,null,null,null,null,null,null,null,null,null,null,"⑨",null,null,null,null,"雨水取付管",null,null,null,null,null,null,"⑨"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番地",null,null,null,null,null,null,null,null,"除害施設",null,null,null,"⑩",null,null,null,null,null,"井水",null,null,null,"⑪",null,null,null,null,null,"念書",null,null,null,"⑫"]
["（所有者）\n申請者",null,null,"現住所",null,null,null,null,null,null,null,null,null,null,"町",null,null,null,"丁目",null,null,null,"番",null,null,"号",null,"特　　定　　施　　設",null,null,null,null,null,null,null,null,null,null,null,"⑬",null,null,null,null,"番　号"]
[null,null,null,"（建物名・部屋番号）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ト　　　　イ　　　　レ",null,null,null,null,null,null,null,null,null,null,null,"新設","洋",null,null,null,"小",null,null,null,"既設","洋",null,null,null,"小"]
[null,null,null,"ふりがな",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"改造内容",null,null,null,"メーター移設",null,null,null,null,null,null,null,"給水装置の減",null,null,null,null,null,null,null,null,"散水栓残し"]
[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,"支分の変更",null,null,null,null,null,null,null,"給水装置の増",null,null,null,null,null,null,null,null,"口径変更"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,"その他（                                                                )"]
["申　請　代　理　人",null,"指定給水装置工事事業者　・　指定排水設備工事事業者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考欄"]
[null,null,"住　所"]
[]
[]
[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,"印"]
[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,"苫小牧市納入金",null,"種　　　　別",null,null,null,null,null,null,null,null,null,"金　　　　額"]
[]
[null,null,"給水装置工事主任技術者",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,"手数料",null,"設　計　審　査"]
[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,"検　　　　　　査"]
[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,"水道利用\n加入金"]
[null,null,"排水設備工事責任技術者",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,"内消費税分"]
[null,null,"氏　名"]
[]
["者の承諾\n家屋所有",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,"相　殺",null,null,"⑭"]
[null,null,null,null,null,null,"住　所"]
[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,"合　計"]
[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,"内消費税分"]
[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,"水道メーター保管及び給排水施設の維持管理"]
["者の承諾\n土地所有",null,null,null,null,null,"承諾地番"]
[null,null,null,null,null,null,"住　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　市上下水道部より貸付された水道メーターは、苫小牧市水道事業給水条例施行規則を守り、責任をもって保管します。\n　また、メーターボックスを含む給水装置及び、排水設備の維持管理についても責任をもって行います。（排水設備について当方の都合で排水設備設計施工要綱を遵守できない場合も含みます。）"]
[]
[null,null,null,null,null,null,"氏　名"]
[]
["者の承諾\n土地所有",null,null,null,null,null,"承諾地番"]
[null,null,null,null,null,null,"住　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現住所",null,null,null,null,null,null,null,null,null,null,null,null,null,"町",null,null,null,"丁目",null,null,null,null,"番",null,null,null,"号"]
[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,"（建物名・部屋番号）"]
[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,"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,"印"]
[]
[]
["支分引用の承諾",null,null,"支管所有者",null,null,"水栓番号",null,null,null,null,null,null,"第",null,null,null,null,null,null,"号",null,null,null,null,null,null,null,null,null,"℡",null,null,null,null,null,null,null,null,null,null,null,null,null,"携帯"]
[null,null,null,null,null,null,"住　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設置場所に転居し、維持管理する。"]
[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,"売却予定であり、売却後、維持管理等全て新所有者へ引き継ぐ。"]
[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,"給水装置所有者代理人を選定。(別紙提出)"]
[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,"※　記　載　上　の　注　意"]
[]
["私設下水管",null,null,"所有者の承諾",null,null,"水栓番号",null,null,null,null,null,null,"第",null,null,null,null,null,null,"号",null,null,null,null,null,null,"1　給水装置・排水設備工事の施行にあたり、申請者がその装置場所、家屋、土地を所有しないとき、また他人の給水管から支分引用及び私設下水管へ接続する場合は、必ず利害関係人の承諾を受けて下さい。\n　後日利害関係人、その他から異議の申し立てがあった場合は、申請者の責任とし、当市はその責任を負いません。\n2　申請書及び完成図書については申請代理人より受理して下さい。\n3　所有者に変更があった場合は、速やかに所有者変更の届出をし、本申請書を引き継いでください。\n4　建物の解体・改築等により給水装置・排水設備の原形を変更する場合は、事前に、市長の承認・確認が必要となるので、再度申請書を提出してください。なお、市長の承認・確認を受けずに給水装置・排水設備の工事を行った場合は、条例違反となります。"]
[null,null,null,null,null,null,"住　所"]
[]
[]
[null,null,null,null,null,null,"氏　名"]
[]
["建築業者名\n(解体業者名)",null,null,null,null,null,"住　所"]
[]
[null,null,null,null,null,null,"氏　名"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"T","E","L","（",null,null,null,null,null,null,null,null,null,"）"]

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[null,null,null,null,null,null,null,null,null,null,null,"給　水　装　置\n排　水　設　備",null,null,null,null,null,null,null,null,null,"新設等承認申請書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※このシートは入力用です。\n提出シート①②を印刷し、\n押印したものを提出して\nください。"]
[]
[null,null,null,"捨印"]
[]
[]
[]
[]
[]
[]
[]
["苫小牧市水道事業"]
[]
[]
["苫　小　牧　市　長　　様",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区　分"]
[]
[]
[]
[]
[]
["受付番号",null,null,null,null,null,"調定番号",null,null,null,null,null,null,"調定年月日",null,null,null,null,null,null,"水道窓口課受付番号",null,null,null,null,null,null,"既   設",null,null,null,null,null,null,null,"第",null,null,null,null,null,null,null,"号",null,"メーター\n口　径",null,null,null,null,"m/m",null,null,"m/m","排水戸数"]
[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,"普通計量栓",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メーター\n個　数",null,null,null,null,"個",null,null,"個"]
[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,null,null,null,"第",null,null,null,null,null,null,null,"号",null,"給　水\n戸　数",null,null,null,null,null,null,null,"戸",null,null,"戸"]
["　手数料及び水道利用加入金については、苫小牧市水道事業給水条例を契約の内容とすることに合意し、同条例第5条及び第32条の規定に基づき、次のとおり申請いたします。",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,"工　　事　　種　　別",null,null,null,null,null,null,null,null,null,null,null,"給　水",null,null,null,null,null,null,null,null,null,"排　水"]
[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,"業　　態　　種　　別",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"検　針　方　式"]
[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,"給　　水　　方　　式",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AN25=\"受水槽\",\"有効容量\",\"\")","v":""},null,null,null,null,null,null,null,null,{"$f":"IF(AN25=\"受水槽\",\"㎥\",\"\")","v":""}]
["建築確認番号",null,null,null,null,null,"第",null,null,null,null,null,null,"号",null,"家屋種別",null,null,null,null,null,null,null,null,null,null,null,"汚　水　公　設　桝",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"汚水取付管"]
["設　置　場　所",null,null,null,null,null,"苫小牧市",null,null,null,null,null,null,null,"町",null,null,null,"丁目",null,null,null,"番",null,null,"号",null,"雨　水　公　設　桝",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"雨水取付管"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番地",null,null,null,null,null,null,null,null,"除害施設",null,null,null,null,null,null,null,null,null,"井水",null,null,null,null,null,null,null,null,null,"念書"]
["（所有者）\n申請者",null,null,"現住所",null,null,null,null,null,null,null,null,null,null,"町",null,null,null,"丁目",null,null,null,"番",null,null,"号",null,"特　　定　　施　　設",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番　号"]
[null,null,null,"（建物名・部屋番号）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ト　　　　イ　　　　レ",null,null,null,null,null,null,null,null,null,null,null,"新設","洋",null,null,null,"小",null,null,null,"既設","洋",null,null,null,"小"]
[null,null,null,"ふりがな",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"改造内容",null,null,null,"メーター移設",null,null,null,null,null,null,null,"給水装置の減",null,null,null,null,null,null,null,null,"散水栓残し"]
[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,"支分の変更",null,null,null,null,null,null,null,"給水装置の増",null,null,null,null,null,null,null,null,"口径変更"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,"その他(",null,null,null,"直結給水への改造",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
["申　請　代　理　人",null,"指定給水装置工事事業者　・　指定排水設備工事事業者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考欄"]
[null,null,"住　所"]
[]
[]
[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,"印"]
[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,"苫小牧市納入金",null,"種　　　　別",null,null,null,null,null,null,null,null,null,"金　　　　額"]
[]
[null,null,"給水装置工事主任技術者",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,"手数料",null,"設　計　審　査"]
[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,"検　　　　　　査"]
[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,"水道利用\n加 入 金"]
[null,null,"排水設備工事責任技術者",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,"内消費税分"]
[null,null,"氏　名"]
[]
["者の承諾\n家屋所有",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,"相　殺"]
[null,null,null,null,null,null,"住　所"]
[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,"合　計"]
[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,"内消費税分",null,null,null,null,{"$f":"AN44","v":0}]
[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,"水道メーター保管及び給排水施設の維持管理"]
["者の承諾\n土地所有",null,null,null,null,null,"承諾地番"]
[null,null,null,null,null,null,"住　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　市上下水道部より貸付された水道メーターは、苫小牧市水道事業給水条例施行規則を守り、責任をもって保管します。\n　また、メーターボックスを含む給水装置及び、排水設備の維持管理についても責任をもって行います。（排水設備について当方の都合で排水設備設計施工要綱を遵守できない場合も含みます。）"]
[]
[null,null,null,null,null,null,"氏　名"]
[]
["者の承諾\n土地所有",null,null,null,null,null,"承諾地番"]
[null,null,null,null,null,null,"住　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現住所",null,null,null,null,null,null,null,null,null,null,null,null,null,"町",null,null,null,"丁目",null,null,null,null,"番",null,null,null,"号"]
[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,"（建物名・部屋番号）"]
[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,"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,"印"]
[]
[]
["支分引用の承諾",null,null,"支管所有者",null,null,"水栓番号",null,null,null,null,null,null,"第",null,null,null,null,null,null,"号",null,null,null,null,null,null,null,null,null,"℡",null,null,null,null,null,null,null,null,null,null,null,null,null,"携帯"]
[null,null,null,null,null,null,"住　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設置場所に転居し、維持管理する。"]
[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,"売却予定であり、売却後、維持管理等全て新所有者へ引き継ぐ。"]
[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,"給水装置所有者代理人を選定。(別紙提出)"]
[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,"※　記　載　上　の　注　意"]
[]
["私設下水管",null,null,"所有者の承諾",null,null,"水栓番号",null,null,null,null,null,null,"第",null,null,null,null,null,null,"号",null,null,null,null,null,null,"1　給水装置・排水設備工事の施行にあたり、申請者がその装置場所、家屋、土地を所有しないとき、また他人の給水管から支分引用及び私設下水管へ接続する場合は、必ず利害関係人の承諾を受けて下さい。\n　後日利害関係人、その他から異議の申し立てがあった場合は、申請者の責任とし、当市はその責任を負いません。\n2　申請書及び完成図書については申請代理人より受理して下さい。\n3　所有者に変更があった場合は、速やかに所有者変更の届出をし、本申請書を引き継いでください。\n4　建物の解体・改築等により給水装置・排水設備の原形を変更する場合は、事前に、市長の承認・確認が必要となるので、再度申請書を提出してください。なお、市長の承認・確認を受けずに給水装置・排水設備の工事を行った場合は、条例違反となります。\n"]
[null,null,null,null,null,null,"住　所"]
[]
[]
[null,null,null,null,null,null,"氏　名"]
[]
["建築業者名\n(解体業者名)",null,null,null,null,null,"住　所"]
[]
[null,null,null,null,null,null,"氏　名"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"T","E","L","（",null,null,null,null,null,null,null,null,null,"）"]

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[null,null,null,null,null,null,null,null,null,null,null,"給　水　装　置\n排　水　設　備",null,null,null,null,null,null,null,null,null,"新設等承認申請書"]
[]
[null,null,null,"捨印"]
[]
[]
[]
[]
[]
[]
[]
["苫小牧市水道事業"]
[]
[]
["苫　小　牧　市　長　　様",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区　分"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!V16","v":0}]
[]
[]
[]
["受付番号",null,null,null,null,null,"調定番号",null,null,null,null,null,null,"調定年月日",null,null,null,null,null,null,"水道窓口課受付番号",null,null,null,null,null,null,{"$f":"入力シート!AB20","v":"既   設"},null,null,null,null,null,null,null,"第",null,{"$f":"入力シート!AL20","v":0},null,null,null,null,null,"号",null,"メーター\n口　径",null,null,{"$f":"入力シート!AW20","v":0},null,"m/m",{"$f":"入力シート!AZ20","v":0},null,"m/m","排水戸数",null,null,null,"このシートは「入力シート」の複写です。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AE21","v":"普通計量栓"},null,null,null,null,null,null,{"$f":"入力シート!AL21","v":0},null,null,null,null,null,null,null,"メーター\n個　数",null,null,{"$f":"入力シート!AW21","v":0},null,"個",{"$f":"入力シート!AZ21","v":0},null,"個",null,null,null,null,"水道課控となります。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,{"$f":"入力シート!AL22","v":0},null,null,null,null,null,"号",null,"給　水\n戸　数",null,null,{"$f":"入力シート!AW22","v":0},null,null,null,null,"戸",{"$f":"入力シート!BC22","v":0},null,"戸",null,"「提出シート②」と併せて提出してください。"]
["　手数料及び水道利用加入金については、苫小牧市水道事業給水条例を契約の内容とすることに合意し、同条例第5条及び第32条の規定に基づき、次のとおり申請いたします。",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,"工　　事　　種　　別",null,null,null,null,null,null,null,null,null,null,null,"給　水",null,null,null,null,{"$f":"入力シート!AS23","v":0},null,null,null,null,"排　水",null,null,null,{"$f":"入力シート!BB23","v":0}]
[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,"業　　態　　種　　別",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN24","v":0},null,null,null,null,"検　針　方　式",null,null,null,null,null,null,{"$f":"入力シート!AZ24","v":0}]
[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,"給　　水　　方　　式",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN25","v":0},null,null,null,null,{"$f":"入力シート!AS25","v":""},null,null,null,null,{"$f":"入力シート!AX25","v":0},null,null,null,{"$f":"入力シート!BB25","v":""}]
["建築確認番号",null,null,null,null,null,"第",null,{"$f":"入力シート!$I$26","v":0},null,null,null,null,"号",null,"家屋種別",null,null,null,null,{"$f":"入力シート!$U$26","v":0},null,null,null,null,null,null,"汚　水　公　設　桝",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN26","v":0},null,null,null,null,"汚水取付管",null,null,null,null,null,null,{"$f":"入力シート!AZ26","v":0}]
["設　置　場　所",null,null,null,null,null,"苫小牧市",null,null,null,{"$f":"入力シート!$K$27","v":0},null,null,null,"町",null,{"$f":"入力シート!Q27","v":0},null,"丁目",null,{"$f":"入力シート!U27","v":0},null,"番",{"$f":"入力シート!X27","v":0},null,"号",null,"雨　水　公　設　桝",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN27","v":0},null,null,null,null,"雨水取付管",null,null,null,null,null,null,{"$f":"入力シート!AZ27","v":0}]
[null,null,null,null,null,null,{"$f":"入力シート!$G$28","v":0},null,null,null,null,null,null,null,null,null,null,null,"番地",null,{"$f":"入力シート!U28","v":0},null,null,null,null,null,null,"除害施設",null,null,null,{"$f":"入力シート!AF28","v":0},null,null,null,null,null,"井水",null,null,null,{"$f":"入力シート!AP28","v":0},null,null,null,null,null,"念書",null,null,null,{"$f":"入力シート!AZ28","v":0}]
["（所有者）\n申請者",null,null,"現住所",null,null,{"$f":"入力シート!G29","v":0},null,null,null,null,null,null,null,"町",null,{"$f":"入力シート!Q29","v":0},null,"丁目",null,{"$f":"入力シート!U29","v":0},null,"番",{"$f":"入力シート!X29","v":0},null,"号",null,"特　　定　　施　　設",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN29","v":0},null,null,null,null,"番　号",null,null,null,null,null,null,{"$f":"入力シート!AZ29","v":0}]
[null,null,null,"（建物名・部屋番号）",null,null,null,null,null,null,null,{"$f":"入力シート!L30","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ト　　　　イ　　　　レ",null,null,null,null,null,null,null,null,null,null,null,"新設","洋",null,{"$f":"入力シート!AQ30","v":0},null,"小",null,{"$f":"入力シート!AU30","v":0},null,"既設","洋",null,{"$f":"入力シート!AZ30","v":0},null,"小",null,{"$f":"入力シート!BD30","v":0}]
[null,null,null,"ふりがな",null,null,{"$f":"入力シート!G31","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"改造内容",null,null,null,"メーター移設",null,null,null,null,null,null,null,"給水装置の減",null,null,null,null,null,null,null,null,"散水栓残し"]
[null,null,null,"氏　名",null,null,{"$f":"入力シート!G32","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支分の変更",null,null,null,null,null,null,null,"給水装置の増",null,null,null,null,null,null,null,null,"口径変更"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,"その他(",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
["申　請　代　理　人",null,"指定給水装置工事事業者　・　指定排水設備工事事業者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考欄",null,{"$f":"入力シート!AD34","v":0}]
[null,null,"住　所",null,null,{"$f":"入力シート!F35","v":0}]
[]
[]
[null,null,"氏　名",null,null,{"$f":"入力シート!F38","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"苫小牧市納入金",null,"種　　　　別",null,null,null,null,null,null,null,null,null,"金　　　　額"]
[]
[null,null,"給水装置工事主任技術者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"手数料",null,"設　計　審　査",null,null,null,null,null,null,null,{"$f":"入力シート!AN41","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX41","v":0}]
[null,null,"氏　名",null,null,{"$f":"入力シート!F42","v":0},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,"検　　　　　　査",null,null,null,null,null,null,null,{"$f":"入力シート!AN42","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX42","v":0}]
[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,"水道利用\n加 入 金",null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN43","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX43","v":0}]
[null,null,"排水設備工事責任技術者",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,"内消費税分",null,null,null,null,{"$f":"入力シート!AN44","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX44","v":0}]
[null,null,"氏　名",null,null,{"$f":"入力シート!F45","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AI45","v":0}]
[]
["者の承諾\n家屋所有",null,null,null,null,null,null,null,null,null,{"$f":"入力シート!K47","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"相　殺",null,null,{"$f":"入力シート!AG47","v":0}]
[null,null,null,null,null,null,"住　所"]
[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,"合　計",null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN49","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX49","v":0}]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K50","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"内消費税分",null,null,null,null,{"$f":"入力シート!AN50","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX50","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"水道メーター保管及び給排水施設の維持管理"]
["者の承諾\n土地所有",null,null,null,null,null,"承諾地番",null,null,null,{"$f":"入力シート!K52","v":0}]
[null,null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K53","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　市上下水道部より貸付された水道メーターは、苫小牧市水道事業給水条例施行規則を守り、責任をもって保管します。\n　また、メーターボックスを含む給水装置及び、排水設備の維持管理についても責任をもって行います。（排水設備について当方の都合で排水設備設計施工要綱を遵守できない場合も含みます。）"]
[]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K55","v":0}]
[]
["者の承諾\n土地所有",null,null,null,null,null,"承諾地番",null,null,null,{"$f":"入力シート!K57","v":0}]
[null,null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K58","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現住所",null,null,null,null,{"$f":"入力シート!AG58","v":0},null,null,null,null,null,null,null,null,"町",{"$f":"入力シート!AQ58","v":0},null,null,"丁目",null,{"$f":"入力シート!AV58","v":0},null,null,"番",{"$f":"入力シート!AZ58","v":0},null,null,"号"]
[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,"（建物名・部屋番号）",null,null,null,null,null,null,null,null,{"$f":"入力シート!AK59","v":0},null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX59","v":0}]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K60","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏　名",null,null,null,null,null,null,{"$f":"入力シート!AI60","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印"]
[]
[]
["支分引用の承諾",null,null,"支管所有者",null,null,"水栓番号",null,null,null,null,null,null,"第",null,{"$f":"入力シート!P63","v":0},null,null,null,null,"号",null,null,null,null,null,null,null,null,null,"℡",{"$f":"入力シート!AF63","v":0},null,null,null,null,null,null,null,null,null,null,null,null,"携帯",null,{"$f":"入力シート!AU63","v":0}]
[null,null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K64","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設置場所に転居し、維持管理する。"]
[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,"売却予定であり、売却後、維持管理等全て新所有者へ引き継ぐ。"]
[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,"給水装置所有者代理人を選定。(別紙提出)"]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K67","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※　記　載　上　の　注　意"]
[]
["私設下水管",null,null,"所有者の承諾",null,null,"水栓番号",null,null,null,null,null,null,"第",null,{"$f":"入力シート!P69","v":0},null,null,null,null,"号",null,null,null,null,null,null,"1　給水装置・排水設備工事の施行にあたり、申請者がその装置場所、家屋、土地を所有しないとき、また他人の給水管から支分引用及び私設下水管へ接続する場合は、必ず利害関係人の承諾を受けて下さい。\n　後日利害関係人、その他から異議の申し立てがあった場合は、申請者の責任とし、当市はその責任を負いません。\n2　申請書及び完成図書については申請代理人より受理して下さい。\n3　所有者に変更があった場合は、速やかに所有者変更の届出をし、本申請書を引き継いでください。\n4　建物の解体・改築等により給水装置・排水設備の原形を変更する場合は、事前に、市長の承認・確認が必要となるので、再度申請書を提出してください。なお、市長の承認・確認を受けずに給水装置・排水設備の工事を行った場合は、条例違反となります。\n"]
[null,null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K70","v":0}]
[]
[]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K73","v":0}]
[]
["建築業者名\n(解体業者名)",null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K75","v":0}]
[]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K77","v":0}]
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[null,null,null,null,null,null,null,null,null,null,null,"給　水　装　置\n排　水　設　備",null,null,null,null,null,null,null,null,null,"新設等承認申請書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申　請　者　用"]
[]
[null,null,null,"捨印"]
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[]
[]
[]
[]
[]
[]
["苫小牧市水道事業"]
[]
[]
["苫　小　牧　市　長　　様",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区　分"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!V16","v":0}]
[]
[]
[]
["受付番号",null,null,null,null,null,"調定番号",null,null,null,null,null,null,"調定年月日",null,null,null,null,null,null,"水道窓口課受付番号",null,null,null,null,null,null,{"$f":"入力シート!AB20","v":"既   設"},null,null,null,null,null,null,null,"第",null,{"$f":"入力シート!AL20","v":0},null,null,null,null,null,"号",null,"メーター\n口　径",null,null,{"$f":"入力シート!AW20","v":0},null,"m/m",{"$f":"入力シート!AZ20","v":0},null,"m/m","排水戸数",null,null,null,"このシートは「入力シート」の複写です。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AE21","v":"普通計量栓"},null,null,null,null,null,null,{"$f":"入力シート!AL21","v":0},null,null,null,null,null,null,null,"メーター\n個　数",null,null,{"$f":"入力シート!AW21","v":0},null,"個",{"$f":"入力シート!AZ21","v":0},null,"個",null,null,null,null,"申請者控となります。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第",null,{"$f":"入力シート!AL22","v":0},null,null,null,null,null,"号",null,"給　水\n戸　数",null,null,{"$f":"入力シート!AW22","v":0},null,null,null,null,"戸",{"$f":"入力シート!BC22","v":0},null,"戸",null,"「提出シート①」と併せて提出してください。"]
["　手数料及び水道利用加入金については、苫小牧市水道事業給水条例を契約の内容とすることに合意し、同条例第5条及び第32条の規定に基づき、次のとおり申請いたします。",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,"工　　事　　種　　別",null,null,null,null,null,null,null,null,null,null,null,"給　水",null,null,null,null,{"$f":"入力シート!AS23","v":0},null,null,null,null,"排　水",null,null,null,{"$f":"入力シート!BB23","v":0}]
[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,"業　　態　　種　　別",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN24","v":0},null,null,null,null,"検　針　方　式",null,null,null,null,null,null,{"$f":"入力シート!AZ24","v":0}]
[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,"給　　水　　方　　式",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN25","v":0},null,null,null,null,{"$f":"入力シート!AS25","v":""},null,null,null,null,{"$f":"入力シート!AX25","v":0},null,null,null,{"$f":"入力シート!BB25","v":""}]
["建築確認番号",null,null,null,null,null,"第",null,{"$f":"入力シート!$I$26","v":0},null,null,null,null,"号",null,"家屋種別",null,null,null,null,{"$f":"入力シート!$U$26","v":0},null,null,null,null,null,null,"汚　水　公　設　桝",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN26","v":0},null,null,null,null,"汚水取付管",null,null,null,null,null,null,{"$f":"入力シート!AZ26","v":0}]
["設　置　場　所",null,null,null,null,null,"苫小牧市",null,null,null,{"$f":"入力シート!$K$27","v":0},null,null,null,"町",null,{"$f":"入力シート!Q27","v":0},null,"丁目",null,{"$f":"入力シート!U27","v":0},null,"番",{"$f":"入力シート!X27","v":0},null,"号",null,"雨　水　公　設　桝",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN27","v":0},null,null,null,null,"雨水取付管",null,null,null,null,null,null,{"$f":"入力シート!AZ27","v":0}]
[null,null,null,null,null,null,{"$f":"入力シート!$G$28","v":0},null,null,null,null,null,null,null,null,null,null,null,"番地",null,{"$f":"入力シート!U28","v":0},null,null,null,null,null,null,"除害施設",null,null,null,{"$f":"入力シート!AF28","v":0},null,null,null,null,null,"井水",null,null,null,{"$f":"入力シート!AP28","v":0},null,null,null,null,null,"念書",null,null,null,{"$f":"入力シート!AZ28","v":0}]
["（所有者）\n申請者",null,null,"現住所",null,null,{"$f":"入力シート!G29","v":0},null,null,null,null,null,null,null,"町",null,{"$f":"入力シート!Q29","v":0},null,"丁目",null,{"$f":"入力シート!U29","v":0},null,"番",{"$f":"入力シート!X29","v":0},null,"号",null,"特　　定　　施　　設",null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN29","v":0},null,null,null,null,"番　号",null,null,null,null,null,null,{"$f":"入力シート!AZ29","v":0}]
[null,null,null,"（建物名・部屋番号）",null,null,null,null,null,null,null,{"$f":"入力シート!L30","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ト　　　　イ　　　　レ",null,null,null,null,null,null,null,null,null,null,null,"新設","洋",null,{"$f":"入力シート!AQ30","v":0},null,"小",null,{"$f":"入力シート!AU30","v":0},null,"既設","洋",null,{"$f":"入力シート!AZ30","v":0},null,"小",null,{"$f":"入力シート!BD30","v":0}]
[null,null,null,"ふりがな",null,null,{"$f":"入力シート!G31","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"改造内容",null,null,null,"メーター移設",null,null,null,null,null,null,null,"給水装置の減",null,null,null,null,null,null,null,null,"散水栓残し"]
[null,null,null,"氏　名",null,null,{"$f":"入力シート!G32","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支分の変更",null,null,null,null,null,null,null,"給水装置の増",null,null,null,null,null,null,null,null,"口径変更"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,"その他(",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
["申　請　代　理　人",null,"指定給水装置工事事業者　・　指定排水設備工事事業者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考欄",null,{"$f":"入力シート!AD34","v":0}]
[null,null,"住　所",null,null,{"$f":"入力シート!F35","v":0}]
[]
[]
[null,null,"氏　名",null,null,{"$f":"入力シート!F38","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"苫小牧市納入金",null,"種　　　　別",null,null,null,null,null,null,null,null,null,"金　　　　額"]
[]
[null,null,"給水装置工事主任技術者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"手数料",null,"設　計　審　査",null,null,null,null,null,null,null,{"$f":"入力シート!AN41","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX41","v":0}]
[null,null,"氏　名",null,null,{"$f":"入力シート!F42","v":0},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,"検　　　　　　査",null,null,null,null,null,null,null,{"$f":"入力シート!AN42","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX42","v":0}]
[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,"水道利用\n加 入 金",null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN43","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX43","v":0}]
[null,null,"排水設備工事責任技術者",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,"内消費税分",null,null,null,null,{"$f":"入力シート!AN44","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX44","v":0}]
[null,null,"氏　名",null,null,{"$f":"入力シート!F45","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AI45","v":0}]
[]
["者の承諾\n家屋所有",null,null,null,null,null,null,null,null,null,{"$f":"入力シート!K47","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"相　殺",null,null,{"$f":"入力シート!AG47","v":0}]
[null,null,null,null,null,null,"住　所"]
[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,"合　計",null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AN49","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX49","v":0}]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K50","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"内消費税分",null,null,null,null,{"$f":"入力シート!AN50","v":0},null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX50","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"水道メーター保管及び給排水施設の維持管理"]
["者の承諾\n土地所有",null,null,null,null,null,"承諾地番",null,null,null,{"$f":"入力シート!K52","v":0}]
[null,null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K53","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　市上下水道部より貸付された水道メーターは、苫小牧市水道事業給水条例施行規則を守り、責任をもって保管します。\n　また、メーターボックスを含む給水装置及び、排水設備の維持管理についても責任をもって行います。（排水設備について当方の都合で排水設備設計施工要綱を遵守できない場合も含みます。）"]
[]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K55","v":0}]
[]
["者の承諾\n土地所有",null,null,null,null,null,"承諾地番",null,null,null,{"$f":"入力シート!K57","v":0}]
[null,null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K58","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現住所",null,null,null,null,{"$f":"入力シート!AG58","v":0},null,null,null,null,null,null,null,null,"町",{"$f":"入力シート!AQ58","v":0},null,null,"丁目",null,{"$f":"入力シート!AV58","v":0},null,null,"番",{"$f":"入力シート!AZ58","v":0},null,null,"号"]
[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,"（建物名・部屋番号）",null,null,null,null,null,null,null,null,{"$f":"入力シート!AK59","v":0},null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"入力シート!AX59","v":0}]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K60","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏　名",null,null,null,null,null,null,{"$f":"入力シート!AI60","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印"]
[]
[]
["支分引用の承諾",null,null,"支管所有者",null,null,"水栓番号",null,null,null,null,null,null,"第",null,{"$f":"入力シート!P63","v":0},null,null,null,null,"号",null,null,null,null,null,null,null,null,null,"℡",{"$f":"入力シート!AF63","v":0},null,null,null,null,null,null,null,null,null,null,null,null,"携帯",null,{"$f":"入力シート!AU63","v":0}]
[null,null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K64","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設置場所に転居し、維持管理する。"]
[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,"売却予定であり、売却後、維持管理等全て新所有者へ引き継ぐ。"]
[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,"給水装置所有者代理人を選定。(別紙提出)"]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K67","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※　記　載　上　の　注　意"]
[]
["私設下水管",null,null,"所有者の承諾",null,null,"水栓番号",null,null,null,null,null,null,"第",null,{"$f":"入力シート!P69","v":0},null,null,null,null,"号",null,null,null,null,null,null,"1　給水装置・排水設備工事の施行にあたり、申請者がその装置場所、家屋、土地を所有しないとき、また他人の給水管から支分引用及び私設下水管へ接続する場合は、必ず利害関係人の承諾を受けて下さい。\n　後日利害関係人、その他から異議の申し立てがあった場合は、申請者の責任とし、当市はその責任を負いません。\n2　申請書及び完成図書については申請代理人より受理して下さい。\n3　所有者に変更があった場合は、速やかに所有者変更の届出をし、本申請書を引き継いでください。\n4　建物の解体・改築等により給水装置・排水設備の原形を変更する場合は、事前に、市長の承認・確認が必要となるので、再度申請書を提出してください。なお、市長の承認・確認を受けずに給水装置・排水設備の工事を行った場合は、条例違反となります。\n"]
[null,null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K70","v":0}]
[]
[]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K73","v":0}]
[]
["建築業者名\n(解体業者名)",null,null,null,null,null,"住　所",null,null,null,{"$f":"入力シート!K75","v":0}]
[]
[null,null,null,null,null,null,"氏　名",null,null,null,{"$f":"入力シート!K77","v":0}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"T","E","L","（",{"$f":"入力シート!Q79","v":0},null,null,null,null,null,null,null,null,"）"]

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["⓪区分",null,"①家屋種別",null,"②種類",null,"③計量栓",null,"④口径"]
[]
["新　　　設",null,"新     築",null,"新   設",null,"普通計量栓",null,13]
["改　　　造",null,"増     築",null,"既   設",null,"臨時計量栓",null,20]
["撤　　　去",null,"既存家屋",null,null,null,"船舶給水栓",null,25]
["臨　　　時",null,null,null,null,null,"特殊排水",null,40]
["排水のみ",null,null,null,null,null,null,null,50]
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[null,null,null,null,null,null,null,null,250]
[]
["⑤工事種別",null,"⑥業態種別",null,"⑦検針方式",null,"⑧給水方式",null,"⑨公設桝・取付管"]
[]
["新　　　設",null,"一般住宅",null,"戸別方式",null,"受水槽",null,"新　設"]
["改　　　造",null,"共同住宅",null,"集中方式",null,"直結直圧",null,"撤　去"]
["撤　　　去",null,"事 務 所",null,"地下方式",null,"直結増圧",null,"取　替"]
[null,null,"店    舗",null,null,null,"直・増圧併用"]
[null,null,"ﾃﾅﾝﾄﾋﾞﾙ"]
[null,null,"工    場"]
[null,null,"宿泊施設"]
[null,null,"医療施設"]
[null,null,"宗    教"]
[null,null,"学    校"]
[null,null,"公共施設"]
[null,null,"そ の 他"]
[]
["⑩除害施設",null,"⑪井　　水",null,"⑫念　書",null,"⑬特定施設",null,"⑭加入金相殺"]
[]
["グリーストラップ",null,"有（メーター有）",null,"有",null,"有",null,"有"]
["ガソリントラップ",null,"有（メーター無）",null,null,null,null,null,"無"]
["ヘアートラップ"]
["プラスタートラップ"]
["ランドリートラップ"]

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[null,"改造種別",false,"メーター移設",false,"給水装置の減",false,"散水栓残し"]
[null,null,false,"支分の変更",false,"給水装置の増",false,"口径変更"]
[null,null,false,"その他（ )"]
[]
[]
[null,null,false,"設置場所に転居し、維持管理する。"]
[null,null,false,"売却予定であり、売却後、維持管理等全て新所有者へ引き継ぐ。"]
[null,null,false,"給水装置所有者代理人を選定。(別紙提出)"]