| ID | 7802 |
|---|---|
| Data | 2019-05-31 |
| Symbol | 2019/05/31/7802 |
| Instytucja | Starostwo Powiatowe w Giżycku |
| Nazwa | Zgłoszenie zamiaru przystąpienia do robót budowlanych niewymagających pozwolenia na budowę |
| Czy Aktualny | 1 |
| Ustawa z dnia 17 lutego 2005 o informatyzacji działalności podmiotów realizujących zadania publiczne |
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<p>
<strong>
<span style="color: #ffffff; font-family: verdana, geneva; font-size: small;">ZGŁOSZENIE ZAMIARU PRZYSTĄPIENIA DO ROBÓT BUDOWLANYCH NIEWYMAGAJĄCYCH POZWOLENIA NA BUDOWĘ<br/></span>
</strong>
</p>
</td>
</tr>
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<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
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<td colspan="2" style="background-color: #ddd9da; border-style: solid; border-width: 1px; border-color: #ddd9da;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">1. ADRESAT</span>
</strong>
</td>
</tr>
<tr>
<td colspan="2" style="border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da; text-align: center;">
<p>
<span style="font-family: verdana, geneva; font-size: small;">Starostwo Powiatowe w Giżycku</span>
<br/>
<span class="LrzXr" style="font-family: verdana, geneva; font-size: small;">Aleja 1 Maja 14</span>
<br/>
<span class="LrzXr" style="font-family: verdana, geneva; font-size: small;">11-500 Giżycko<br/>Wydział Budownictwa</span>
</p>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">
<strong>2. RODZAJ WNIOSKODAWCY</strong>
</span>
</td>
</tr>
<tr>
<td colspan="2" style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<p> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:if test="true()"><span><xsl:choose><xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:Wartosc/wnio:ID0) = normalize-space(' 1 ')"><span>[<b>X</b>]</span></xsl:when><xsl:otherwise><span>[
]</span></xsl:otherwise></xsl:choose><label><span>Osoba
fizyczna
</span></label></span><span><xsl:choose><xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:Wartosc/wnio:ID0) = normalize-space(' 2 ')"><span>[<b>X</b>]</span></xsl:when><xsl:otherwise><span>[
]</span></xsl:otherwise></xsl:choose><label><span>Inwestor
</span></label></span></xsl:if></span></span></p>
</td>
</tr>
<tr>
<td colspan="2">
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID1">
<xsl:if test="//wnio:TrescDokumentu/wnio:Wartosc/wnio:ID0='1'">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td colspan="2" style="background-color: #ddd9da; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">
<strong>3. DANE WNIOSKODAWCY<br/></strong>
</span>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">Imię</span>
</td>
<td>
<p> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID3"/></span></xsl:if></span></span></p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Nazwisko</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID4"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">
<strong>4. ADRES ZAMIESZKANIA</strong>
</span>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="font-family: verdana, geneva; font-size: small; text-align: center; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">Województwo</td>
<td style="border-bottom: 1px solid #ddd9da;">
<p> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID5"/></span></xsl:if></span><br/></p>
</td>
</tr>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;"> Gmina</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID7"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="text-align: center; width: 30%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">Powiat</span>
</td>
<td style="border-bottom: 1px solid #ddd9da;">
<p> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID6"/></span></xsl:if></span><br/></p>
</td>
</tr>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Miejscowość</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID8"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Ulica</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID9"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Numer budynku</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID11"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Numer lokalu</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID12"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Kod pocztowy<br/></span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID31"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">
<strong>5. ADRES DO KORESPONDENCJI<br/></strong>
</span>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="font-family: verdana, geneva; font-size: small; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Województwo</span>
</td>
<td style="border-bottom: 1px solid #ddd9da;">
<p> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID18"/></span></xsl:if></span><br/></p>
</td>
</tr>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;"> <span style="font-family: verdana, geneva; font-size: small;">Gmina</span></span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID20"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="font-family: verdana, geneva; font-size: small; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Powiat</span>
</td>
<td style="border-bottom: 1px solid #ddd9da;">
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID19"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Miejscowość</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID21"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Ulica</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID37"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Numer budynku</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID62"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Numer lokalu</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID63"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Kod pocztowy</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID64"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">
<strong>6. KONTAKT</strong>
</span>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;"> Numer telefonu</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID13"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;"> E-mail</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID14"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td colspan="2">
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID2">
<xsl:if test="//wnio:TrescDokumentu/wnio:Wartosc/wnio:ID0='2'">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td colspan="2" style="background-color: #ddd9da; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">
<strong>3. DANE DOTYCZĄCE INWESTORA<br/></strong>
</span>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">Imię</span>
</td>
<td>
<p> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID15"/></span></xsl:if></span></span></p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Nazwisko<br/></span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID16"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Nazwa inwestora<br/></span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID17"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;"> </td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">4. ADRES ZAMIESZKANIA LUB SIEDZIBY<br/></span>
</strong>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="text-align: center; width: 30%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Województwo</span>
</span>
</td>
<td style="border-bottom: 1px solid #ddd9da;">
<p> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID38"/></span></xsl:if></span></span><br/></p>
</td>
</tr>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Gmina</span>
</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID40"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="font-family: verdana, geneva; font-size: small; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; text-align: center;">
<p>
<span style="font-family: verdana, geneva; font-size: small;">Powiat</span>
</p>
</td>
<td>
<p style="font-family: verdana, geneva; font-size: small; border-bottom: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID39"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Miejscowość</span>
</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID41"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Ulica</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID42"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Numer budynku</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID22"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Numer lokalu</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID23"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Kod pocztowy</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID24"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">5. ADRES DO KORESPONDENCJI<br/></span>
</strong>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="text-align: center; width: 30%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Województwo</span>
</span>
</td>
<td style="border-bottom: 1px solid #ddd9da;">
<p> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID45"/></span></xsl:if></span><br/></p>
</td>
</tr>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Gmina</span>
</span>
</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID47"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="font-family: verdana, geneva; font-size: small; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; text-align: center;">
<p>
<span style="font-family: verdana, geneva; font-size: small;">Powiat</span>
</p>
</td>
<td>
<p style="font-family: verdana, geneva; font-size: small; border-bottom: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID46"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Miejscowość</span>
</span>
</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID48"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Ulica</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID49"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Numer budynku</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID43"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Numer lokalu</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID44"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">Kod pocztowy</span>
</span>
</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID58"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<span style="font-size: small;">
<strong>
<span style="font-family: verdana, geneva;">6.
KONTAKT</span>
</strong>
</span>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Numer telefonu</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID25"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">E-mail</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID26"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td colspan="2" style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID33">
<xsl:if test="true()">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 100%; border-bottom: 1px solid #ddd9da;">
<p style="font-family: verdana, geneva; font-size: small; background-color: #ddd9da;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">7. TREŚĆ WNIOSKU</span>
</strong>
</p>
</td>
</tr>
<tr>
<td style="width: 100%; border-bottom: 1px solid #ddd9da;">
<p>
<span style="font-family: verdana, geneva; font-size: small;">Na podstawie art. 30 ust. 1, art 29 ust. 1 ustawy
z dnia 7 lipca 1994r. Prawo budowlane zgłaszam
zamiar wykonania robót budowlanych:</span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID30"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
<tr>
<td style="width: 100%; border-bottom: 1px solid #ddd9da;"> <span style="font-family: verdana, geneva; font-size: small;">Na działce:</span><br/><table border="0" cellpadding="0" cellspacing="0" style="width: 100%;"><tbody><tr><td style="width: 50%;"><table border="0" cellpadding="0" cellspacing="0" style="width: 100%;"><tbody><tr><td style="width: 30%; border-bottom: 1px solid #ddd9da; border-top: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: center;"><span style="font-family: verdana, geneva; font-size: small;"> Numer geodezyjny</span></td><td style="width: 70%; border-bottom: 1px solid #ddd9da; border-top: 1px solid #ddd9da; border-right: 1px solid #ddd9da;"><p> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID32"/></span></xsl:if></span></span></p></td></tr></tbody></table></td><td style="width: 50%;"><table border="0" cellpadding="0" cellspacing="0" style="width: 100%;"><tbody><tr><td style="width: 30%; border-bottom: 1px solid #ddd9da; border-top: 1px solid #ddd9da; border-right: 1px solid #ddd9da;"><span style="font-family: verdana, geneva; font-size: small;"> Miejscowość</span></td><td style="width: 70%; border-bottom: 1px solid #ddd9da; border-top: 1px solid #ddd9da;"><p> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID34"/></span></xsl:if></span></span></p></td></tr></tbody></table></td></tr><tr><td style="width: 50%;"><table border="0" cellpadding="0" cellspacing="0" style="width: 100%;"><tbody><tr><td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;"><span style="font-family: verdana, geneva; font-size: small;">Ulica</span></td><td style="border-right: 1px solid #ddd9da;"><p> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID35"/></span></xsl:if></span></span></p></td></tr></tbody></table></td><td style="width: 50%;"><table border="0" cellpadding="0" cellspacing="0" style="width: 100%;"><tbody><tr><td style="width: 30%; border-right: 1px solid #ddd9da;"><span style="font-family: verdana, geneva; font-size: small;">Dzień wykonania robót</span></td><td><p> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID36"/></span></xsl:if></span></span></p></td></tr></tbody></table></td></tr></tbody></table></td>
</tr>
<tr>
</tr>
<tr>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">8. ZAŁĄCZNIKI</span>
</strong>
</td>
</tr>
<tr>
</tr>
<tr>
<td colspan="2" style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID27">
<xsl:if test="true()">
<span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:value-of select="wnio:TrescDokumentu/str:Zalaczniki/str:Zalacznik/str:DaneZalacznika/../@nazwaPliku"/></span><br/>Nazwa załącznika:
<span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID57"/></span></xsl:if></span></span>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">9. PODPIS WNIOSKODAWCY</span>
</strong>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Imię</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID10"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="width: 50%; border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da;">
<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Nazwisko</span>
</td>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;"> <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID28"/></span></xsl:if></span></span>
</p>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td colspan="2" style="border-right: 1px solid #ddd9da; border-bottom: 1px solid #ddd9da; border-left: 1px solid #ddd9da;">
<p style="text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">Data wypełnienia</span>
<br/>
<span style="font-family: verdana, geneva; font-size: small;">
<xsl:if test="true()">
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID29"/>
</xsl:if>
</span>
</p>
</td>
</tr>
</tbody>
</table>
<table align="right">
<tr>
<td style="width: 100%;">
<p/>
<p/>
<p align="right" style="text-align: left;font-size: small;font-family: verdana, geneva;line-height: 20px;">
<xsl:choose>
<xsl:when test="string-length(//wnio:Dokument/ds:Signature/ds:SignatureValue) > 0">
<xsl:text>Dokument został podpisany, aby go zweryfikować należy użyć oprogramowania do weryfikacji podpisu </xsl:text>
<br/>
<xsl:for-each select="//wnio:Dokument/ds:Signature/ds:Object">
<xsl:if test="descendant::*[local-name() = 'SigningTime']">
<xsl:value-of select="descendant::*[local-name() = 'SigningTime']"/>
</xsl:if>
<br/>
<xsl:choose>
<xsl:when test="descendant::*[local-name() = 'PodpisZP']">
Podpis profilem zaufanym: <xsl:value-of select="descendant::*[local-name() = 'Imie']"/><xsl:text> </xsl:text><xsl:value-of select="descendant::*[local-name() = 'Nazwisko']"/><br/></xsl:when>
</xsl:choose>
</xsl:for-each>
</xsl:when>
<xsl:otherwise>
<xsl:text>Dokument nie zawiera podpisu</xsl:text>
</xsl:otherwise>
</xsl:choose>
<br/>
</p>
</td>
</tr>
</table>
</body>
</html>
</xsl:for-each>
</xsl:template>
</xsl:stylesheet>