<p style='text-align: center;'><span style='font-size: 12pt;'><em><span class='mce_maj' style='text-align: center; font-weight: bold; font-family: helvetica;'><span class='field_value pre'><span class='field_value pre'>Ville &amp;delaville</span></span><span class='field_value pre'><span class='field_value pre'><br /></span></span></span><span class='mce_maj' style='text-align: center; font-family: helvetica;'><span class='field_value pre'><span class='field_value pre'>&amp;libelle_direction</span></span></span></em></span></p>
<p style='text-align: center;'><span style='font-size: 12pt;'> </span></p>
<p style='text-align: center;'><span style='font-size: 12pt;'><em><span class='mce_maj'><span style='text-align: center; font-weight: bold; font-family: helvetica;'><span class='field_value pre'>[libelle_om_lettretype]</span></span></span></em></span></p>
<p style='text-align: center;'><span style='font-size: 12pt;'><em><span class='mce_maj'><span style='text-align: center; font-weight: bold; font-family: helvetica;'><span class='field_value pre'>pour travaux non conformes</span></span></span></em></span></p>
<div style='text-align: center;'><span style='font-family: helvetica; font-size: 9pt;'>Si vous souhaitez obtenir des informations sur votre dossier, adressez-vous :</span></div>
<div style='text-align: center;'><span style='font-family: helvetica; font-size: 9pt;'>Commune &amp;DELAVILLE</span></div>
<div style='text-align: center;'><span style='font-family: helvetica; font-size: 8pt;'><span class='mce_maj' style='font-size: 9pt;'>&amp;adresse_service_municipal_empl</span><br /> </span></div>
<table style='width: 92%; height: 20px; margin-left: auto; margin-right: auto;' border='1' cellpadding='5'>
<tbody>
<tr>
<td style='width: 60%;'>
<p><span class='mce_codebarre' style='font-size: 9pt; font-family: helvetica;'>[code_barres_dossier]</span></p>
<p><span style='font-size: 9pt; font-family: helvetica;'><span style='font-family: helvetica;'>Dossier :       <span style='font-weight: bold;'><span class='field_value pre'><span class='field_value pre'>[libelle_da]</span></span></span></span></span></p>
<p><span style='font-size: 9pt;'> </span></p>
<p><span style='font-size: 9pt; font-family: helvetica;'>Déposé le :   <span class='field_value pre'><span class='field_value pre'><span class='field_value pre'><span class='field_value pre'>[date_depot_dossier]</span></span></span></span></span></p>
<p><span style='font-size: 9pt;'> </span></p>
<p><span style='font-size: 9pt; font-family: helvetica;'><span class='field_value pre'><span class='field_value pre'><span class='field_value pre'><span class='field_value pre'><span style='text-decoration: underline;'>Nature des travaux</span> :</span></span></span></span></span></p>
<p><span style='font-size: 9pt; font-family: helvetica;'><span class='field_value pre'><span class='field_value pre'><span class='field_value pre'><span class='field_value pre'><span class='mce_maj' style='font-weight: bold;'>[projet_desc_donnees_techniques]</span></span></span></span></span></span></p>
<p><span style='font-size: 9pt;'> </span></p>
<p><span style='font-size: 9pt; font-family: helvetica;'><span style='text-decoration: underline;'>Adresse des travaux</span> :</span></p>
<p><span style='font-size: 9pt;'> </span></p>
<p><span class='field_value pre' style='font-size: 9pt; font-family: helvetica; font-weight: bold;'><span class='field_value pre mce_maj'>[terrain_adresse_voie_numero_dossier] [terrain_adresse_voie_dossier]</span></span></p>
<p><span class='field_value pre' style='font-size: 9pt; font-family: helvetica; font-weight: bold;'><span class='field_value pre mce_maj'>[terrain_adresse_lieu_dit_dossier] </span><span class='field_value pre mce_maj'>[terrain_adresse_bp_dossier]</span></span></p>
<p><span class='field_value pre' style='font-size: 9pt; font-family: helvetica; font-weight: bold;'><span class='field_value pre mce_maj'>[terrain_adresse_code_postal_dossier] [terrain_adresse_localite_dossier] [terrain_adresse_cedex_dossier]</span></span></p>
<p><span style='font-size: 9pt;'> </span></p>
</td>
<td>
<p><span style='font-family: helvetica; font-size: 9pt;'><span style='text-decoration: underline;'>Demandeur</span> :       <span class='mce_codebarre'>[code_barres_instruction]<br /></span></span></p>
<p><span class='mce_maj' style='font-family: helvetica; font-size: 9pt; font-weight: bold;'>[nom_correspondant]</span></p>
<p><span style='font-size: 9pt;'> </span></p>
<p><span class='mce_maj' style='font-family: helvetica; font-size: 9pt; font-weight: bold;'>[numero_correspondant] [voie_correspondant]</span></p>
<p><span class='mce_maj' style='font-family: helvetica; font-size: 9pt; font-weight: bold;'>[complement_correspondant] - [lieu_dit_correspondant]</span></p>
<p><span class='mce_maj' style='font-family: helvetica; font-size: 9pt; font-weight: bold;'>[bp_correspondant]</span></p>
<p><span class='mce_maj' style='font-family: helvetica; font-size: 9pt; font-weight: bold;'>[code_postal_correspondant] [ville_correspondant] [cedex_correspondant]</span></p>
<p><span class='mce_maj' style='font-family: helvetica; font-size: 9pt; font-weight: bold;'>[pays_correspondant]</span></p>
</td>
</tr>
<tr>
<td colspan='2'>
<p><span style='font-size: 9pt; font-family: helvetica;'>&amp;contraintes(liste_groupe=Zones Du Plu)Destination - surface de plancher créée : <span class='field_value pre'>[tab_surface_donnees_techniques]</span></span></p>
<p><span style='font-size: 9pt; font-family: helvetica;'><span class='field_value pre'>Références cadastrales : [terrain_references_cadastrales_dossier]</span></span></p>
</td>
</tr>
</tbody>
</table>