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Angaben zum Baugrundstck 2.1 Gemarkung:  FORMTEXT Ofterdingen 2.2 Grundstck:  FORMTEXT       2.3 Flurstck:  FORMTEXT        A Antrag auf Genehmigung und  FORMCHECKBOX  Neuanschluss an die ffentliche Wasserversorgungsanlage  FORMCHECKBOX  Herstellung einer zustzlichen ffentlichen Wasserversorgungsanschlussleitung  FORMCHECKBOX  nderung der ffentlichen Wasserversorgungsanschlussleitung B Bei dem Bauvorhaben handelt es sich um eine/einen  FORMCHECKBOX  Neubau  FORMCHECKBOX  Altbau  FORMCHECKBOX  Erweiterung/Umbau C Entnahmestellen  FORMTEXT       Bder/Duschen  FORMTEXT       Splaborte  FORMTEXT       Kchen   FORMTEXT       Waschbecken  FORMTEXT       Garagenanschluss  FORMTEXT       Gartenanschluss   FORMTEXT       Sonstiges:  FORMTEXT        Geschtzter Wasserbedarf  FORMTEXT       m/Tag  D Eigenwasserversorgung Ist eine Eigenwasserversorgung vorhanden oder geplant (Brunnen, Zisterne)?  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Planverfasser Name:  FORMTEXT        Anschrift:  FORMTEXT        Telefon:  FORMTEXT        2. Bauleiter Name:  FORMTEXT        Anschrift:  FORMTEXT        Telefon:  FORMTEXT        3. Mit dem Anschluss beauftragtes Installationsunternehmen Name:  FORMTEXT        Anschrift:  FORMTEXT        Telefon:  FORMTEXT        G Planunterlagen Dem Antrag sind 2-fach beigefgt: Lageplan (M 1:500) nebst Beschreibung und Skizze der geplanten Anlage des Anschlussnehmers (Wasserverbrauchsanlage) Nhere Beschreibung der besonderen Einrichtungen, fr die auf dem Grundstck Wasser verwendet werden soll ___ _______________ (Ort, Datum) (Anschlussnehmer) (Bauleiter) Prfung und Genehmigungsvermerk: Ofterdingen, den ________________ (Siegel) ____________________________________     Stand 04/2014 b@d@f@@@@@@@@@@AAA:A*CJOJQJ^JaJh %5CJOJQJ^JaJhDK+5CJOJQJ^JaJh %CJOJQJ^JaJ.jhp,CJOJQJU^JaJmHnHuh-CJOJQJ^JaJ.jhDK+CJOJQJU^JaJmHnHu)jhDK+CJOJQJU^JaJ#jhDK+CJOJQJU^JaJ)j@hDK+CJOJQJU^JaJhDK+CJOJQJ^JaJ*B,B.B0B>B@BTBVBXBbBdBfBhBjBlBBBBBBBBBB°›k]°Hk)jh %CJOJQJU^JaJhvoCJOJQJ^JaJ.jhvoCJOJQJU^JaJmHnHu.jh %CJOJQJU^JaJmHnHu)j@h %CJOJQJU^JaJ#jh %CJOJQJU^JaJh %CJOJQJ^JaJh %5CJOJQJ^JaJ hhCJOJQJ^JaJh %>*CJOJQJ^JaJlBBBBBBCCPCXCCCCCCZD\DDDDDE"E$E 7$8$H$gd 7$8$H$gd % 7$8$H$gd %BBBBBBBBBBBBBBCCCC(C*C>CӬ|m^P>P#jhCJOJQJU^JaJhCJOJQJ^JaJh5CJOJQJ^JaJh %>*CJOJQJ^JaJ.jhvoCJOJQJU^JaJmHnHu.jh %CJOJQJU^JaJmHnHu)j,h %CJOJQJU^JaJ#jh %CJOJQJU^JaJh %CJOJQJ^JaJ hhCJOJQJ^JaJhCJOJQJ^JaJ>C@CBCLCNCPCRCVCXCpCrCCCCCCCCCCCCCCCCCز{زfزX{زC)jhCJOJQJU^JaJhvoCJOJQJ^JaJ)jhCJOJQJU^JaJ hhCJOJQJ^JaJhCJOJQJ^JaJ.jhvoCJOJQJU^JaJmHnHuhCJOJQJ^JaJ.jhCJOJQJU^JaJmHnHu#jhCJOJQJU^JaJ)jhCJOJQJU^JaJCCCCCC(DDDZD\D^DlDnDDDDDDDD̻nYnAn.jhCJOJQJU^JaJmHnHu)jhCJOJQJU^JaJ#jhCJOJQJU^JaJh5CJOJQJ^JaJhIk>*CJOJQJ^JaJh %>*CJOJQJ^JaJh %CJOJQJ^JaJ hhCJOJQJ^JaJhvoCJOJQJ^JaJ.jhvoCJOJQJU^JaJmHnHuhCJOJQJ^JaJDDDDDDDDDDDDDDD E EEEEEE E"EϢ|kVϢ|B&hvoh5>*CJOJQJ^JaJ)jhCJOJQJU^JaJ hhCJOJQJ^JaJhCJOJQJ^JaJ.jhvoCJOJQJU^JaJmHnHu.jhCJOJQJU^JaJmHnHu)jzhCJOJQJU^JaJ#jhCJOJQJU^JaJhCJOJQJ^JaJ hvohvoCJOJQJ^JaJ"E$E&E0ENEPERErE~EEEEE|F~FPGRGTGVG\GbGѰzzk[K;h~h S[>*CJOJQJaJh~hr^>*CJOJQJaJh~h~>*CJOJQJaJh~htCJOJQJaJhDK+OJQJ^JhTOJQJ^Jh)OJQJ^Jh-h)5OJQJ^Jh\*OJQJ^J#h\*ht5CJ OJQJ^JaJ h\*5CJOJQJ^JaJhb5CJOJQJ^JaJhDK+5CJOJQJ^JaJ h %h %CJOJQJ^JaJ$EPEREE~FRGTGVGGGGGGGG>H@HBHHHHII 3p]pgd_$ 3p]pa$gd! & F7$8$H$^gd\* 7$8$H$gdt 7$8$H$gd\*bGdGjGlGGGGGGGGGGGG>HHHHȻvvjZK?0h_h_CJ OJQJaJ h_CJOJQJaJh_h_CJOJQJaJh_h_5CJOJQJaJh_CJOJQJaJhTCJOJQJaJhCJOJQJaJh~h%?SCJOJQJaJh~hr^CJOJQJaJhThNbCJOJQJaJh>*CJOJQJaJhT>*CJOJQJaJhCJOJQJaJh~h%?S>*CJOJQJaJh~h%?SCJOJQJaJHHHHHHIII IIII&I(I*I,I.I0IȺȺȶhTh:nCJOJQJ^JaJ hThTCJOJQJ^JaJhljhlUh_h_CJOJQJaJh_CJOJQJaJIII II*I,I.I0I 3p]pgd_$a$gdT< 0 0&P 1:pu+]. 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