옥외광고물등안전도검사필증

[별지 제5호서식] <개정 1997.2.6, 2001.11.22>
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┃제    호                                                                  ┃
┃                        

2-1--안전도검사필증.txt

                   ┃
┃                                                                          ┃
┠────┬─────┬────────┬────────┬────────┨
┃        │①성    명│                │ ②주민등록번호 │                ┃
┃        ├─────┼────────┴────────┴────────┨
┃신 청 자│③업 소 명│                                                    ┃
┃        ├─────┼──────────────────────────┨
┃        │④주    소│                                                    ┃
┠────┴─────┼────────┬─────────┬───────┨
┃⑤ 광고물등 허가일  │                │⑥광고물등의 종류 │              ┃
┃   자  및   번  호  │                │                  │              ┃
┠──────────┼────────┼─────────┼───────┨
┃⑦ 표시위치또는장소 │                │⑧광고물등의 규격 │              ┃
┠────┬─────┼────────┼─────────┼───────┨
┃        │⑨대 표 자│                │⑩신   고   번  호│              ┃
┃시공업소├─────┼────────┼─────────┼───────┨
┃        │⑪업 소 명│                │⑫주            소│              ┃
┠────┼─────┼────────┼─────────┼───────┨
┃        │⑬성    명│                │⑭검   사   일  자│              ┃
┃검 사 자├─────┼────────┼─────────┼───────┨
┃        │⑮소    속│                │<16>주          소│              ┃
┠────┴─────┼────────┴─────────┴───────┨
┃<17>검  사   결  과 │                                                    ┃
┠──────────┴──────────────────────────┨
┃                                                                          ┃
┃    옥외광고물등관리법 제9조 및 동법시행령 제39조제3항의 규정에 의하여 위 ┃
┃                                                                          ┃
┃  와 같이 안전도검사를 필하였음을 확인합니다.                             ┃
┃                                                                          ┃
┃                                                                          ┃
┃                                                                          ┃
┃                            년      월      일                            ┃
┃                                                                          ┃
┃                                                         ┌─┐           ┃
┃                                   시장·군수·구청장    │인│           ┃
┃                                                         └─┘           ┃
┃                                                                          ┃
┃                                                                          ┃
┃                                                                          ┃
┗━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━┛
 21026-30111일                                                   210mm×297mm
 96.9.4 승인                                           (보존용지(2종) 70g/㎡)