7/17/2019 BERITA ACARA PERSETUJUAN LOKASI SURVEY.doc

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KOP PU PROPINSI

BERITA ACARAPERSETUJUAN LOKASI SURVEI

Pada hari ini, ......................... tanggal ................. bulan ........................... tahun2015, bertempat di :

Satuan Kerja : ................................................................................................................................................................. 

.................................................................................................................................................................

Prpin!i : .................................................................................................................................................................

"elah dila#u#an di!#u!i tentang pemilihan l#a!i !ur$e% untu# #egiatan PemutakhiranData Kawasan Permukiman Perdesaan P!tensia" Tertin##a" Ter$en%i" Dan Pu"auPu"au Ke%i" Di &i"a'ah Ba"i Nusa Ten##ara (a"uku Dan Pa$ua)

Setelah memperhati#an dan mempertimbang#an berbagai hal, diperleh ha!il #e!epa#atanl#a!i !ur$e% adalah !ebagai beri#ut :

Prpin!i : .................................................................................................................................................................

Kabupaten : 1. .........................................................................................................................................................

2. .........................................................................................................................................................

&. .........................................................................................................................................................

'. .........................................................................................................................................................

(emi#ian berita a)ara ini dibuat untu# ditaati dan diperguna#an !ebagaimaname!tin%a

................., .................... 2015

K!nsu"tan * Sur+e'!r SATKER PROPINSI

*.................................+ *.......................................+NIP. : ...............................