| ID | 8565 |
|---|---|
| Data | 2019-09-17 |
| Symbol | 2019/09/17/8565 |
| Instytucja | Urząd Miejski w Mrągowie |
| Nazwa | WNIOSEK O UZYSKANIE ZEZWOLENIA W ZAKRESIE PROWADZENIA SCHRONISK DLA BEZDOMNYCH ZWIERZĄT |
| 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;"> WNIOSEK O UZYSKANIE ZEZWOLENIA W ZAKRESIE
PROWADZENIA SCHRONISK DLA BEZDOMNYCH
ZWIERZĄT<br/></span>
</strong>
</p>
</td>
</tr>
</tbody>
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<table border="0" cellpadding="0" cellspacing="0" style="width: 100%;">
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<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;">Urząd Miejski w Mrągowie<br/>ul. Królewiecka 60A<br/>11-700 Mrągowo</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>Instytucja
</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</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;">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="width: 30%; border-right: 1px solid #ddd9da; text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;"> Województwo</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></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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;">Powiat</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></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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;">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:ID9"/></span></xsl:if></span></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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;">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:ID11"/></span></xsl:if></span></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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:ID12"/></span></xsl:if></span></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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<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 style="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:ID5"/></span></xsl:if></span></span></p>
</td>
</tr>
</tbody>
</table>
</td>
<td style="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</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:ID6"/></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. 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!='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 INSTYTUCJI</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;">Nazwa instytucji</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;">Skrócona nazwa</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;">NIP</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;">
<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;">REGON</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:ID18"/></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;">4. ADRES SIEDZIBY</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;">Województwo</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:ID43"/></span></xsl:if></span></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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;">Powiat</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:ID44"/></span></xsl:if></span></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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;">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:ID45"/></span></xsl:if></span></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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;">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:ID46"/></span></xsl:if></span></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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:ID47"/></span></xsl:if></span></span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;"/>
</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<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:ID24"/></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:ID41"/></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</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:ID42"/></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;">5.
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="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;">6. TREŚĆ WNIOSKU</span>
</strong>
</td>
</tr>
<tr>
<td colspan="2" 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 colspan="2" style="width: 50%; text-align: justify; border-bottom: 1px solid #ddd9da;">
<span style="font-family: verdana, geneva; font-size: small;">Zgodnie z art. 7 ust. 1 pkt 4 ustawy z dnia 13
września 1996 r. o utrzymaniu czystości i porządku
w gminach wnoszę o wydanie zezwolenia w
zakresie prowadzenia schronisk dla bezdomnych
zwierząt na terenie Miasta Mrągowo.</span>
</td>
</tr>
<tr>
<td style="width: 50%; border-bottom: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Przedmiot wykonywanej działalności:</span>
</td>
<td style="width: 50%; 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:ID32"/></span></xsl:if></span></span>
</p>
</td>
</tr>
<tr>
<td style="width: 50%; border-bottom: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Obszar wykonywanej działalności:</span>
</td>
<td style="width: 50%; 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:ID33"/></span></xsl:if></span></span>
</p>
</td>
</tr>
<tr>
<td style="width: 50%; border-bottom: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Środki techniczne, jakimi dysponuje
ubiegający się o zezwolenie, mające na celu
zapewnienie prawidłowego wykonywania zadań
objętych wnioskiem:</span>
</td>
<td style="width: 50%; 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:ID34"/></span></xsl:if></span></span>
</p>
</td>
</tr>
<tr>
<td style="width: 50%; border-bottom: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Informacje o technologiach stosowanych lub
przewidzianych do stosowania przy świadczeniu
usług w zakresie działalności objętej
wnioskiem:</span>
</td>
<td style="width: 50%; 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:ID35"/></span></xsl:if></span></span>
</p>
</td>
</tr>
<tr>
<td style="width: 50%; border-bottom: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Proponowane zabiegi w zakresie ochrony środowiska
i ochrony sanitarnej planowane po zakończeniu
działalności:</span>
</td>
<td style="width: 50%; 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:ID36"/></span></xsl:if></span></span>
</p>
</td>
</tr>
<tr>
<td style="width: 50%; border-bottom: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Określenie terminu podjęcia działalności objętej
wnioskiem oraz zamierzonego czasu jej
prowadzenia:</span>
</td>
<td style="width: 50%; 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:ID37"/></span></xsl:if></span></span>
</p>
</td>
</tr>
<tr>
<td colspan="2" style="background-color: #ddd9da; width: 50%; border-bottom: 1px solid #ddd9da;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">7. OPIS WYPOSAŻENIA NIERUCHOMOŚCI, NA KTÓREJ
BĘDZIE PROWADZONA DZIAŁALNOŚĆ OBJĘTA
WNIOSKIEM</span>
</strong>
</td>
</tr>
<tr>
<td style="width: 50%; border-bottom: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Utwardzenie i ogrodzenie terenu:</span>
</td>
<td style="width: 50%; 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>
</p>
</td>
</tr>
<tr>
<td style="width: 50%; border-bottom: 1px solid #ddd9da; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Obiekt przeznaczony do przebywania zwierząt:
</span>
</td>
<td style="width: 50%; 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:ID39"/></span></xsl:if></span></span>
</p>
</td>
</tr>
<tr>
<td style="width: 50%; border-right: 1px solid #ddd9da; text-align: justify;">
<span style="font-family: verdana, geneva; font-size: small;">Urządzenia do przygotowywania i przechowywania
żywności dla zwierząt:</span>
</td>
<td style="width: 50%;">
<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></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;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">8. ZAŁĄCZNIKI</span>
</strong>
</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:ID27">
<xsl:if test="true()">
<span style="background-color: #ffffff; display: block; font-family: verdana, geneva; font-size: x-small;"> Załącznik:
<xsl:value-of select="wnio:TrescDokumentu/str:Zalaczniki/str:Zalacznik/str:DaneZalacznika/../@nazwaPliku"/>
</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>