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[null,null,null,null,null,null,null,"令和　　　年　　　月　　　日"]
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[]
["　　東京都第三建設事務所長 殿"]
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[]
[]
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["街　路　事　業　計　画　線 （　高　 さ　） 指　示　願"]
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[]
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["　　　１．　申請場所（土地の地番）"]
[]
[]
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["　　　２．　土地所有者"]
[null,null,null,"住　　所："]
[]
[null,null,null,"氏　　名：",null,null,null,null,null,"㊞"]
[]
[null,null,null,"電　　話：","（　　　　）"]
[]
["　　　　　　実務取扱者"]
[null,null,null,"住　　所："]
[]
[null,null,null,"氏　　名：",null,null,null,null,null,"㊞"]
[]
[null,null,null,"電　　話：","（　　　　）"]
[]
[]
["　　　３．　申請目的"]
[null,null,"□","構造物等の建築のため",null,null,"（種類：","　　　　　　　　　　　　　　　）"]
[null,null,"□","土地の　合筆　・　分筆　・　地積更正　　のため"]
[null,null,"□","その他　（",null,null,null,null,null,"　 　　）"]
[]
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[null,"   上記について東京都都市計画街路　　　　　　第　　　号線の計画線及び計画高を"]
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[null,"現地に指示願いたい。"]
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["　　　４．　添付書類　       案内図　・　公図写　・　登記簿謄本　・　地積測量図　"]
["　　　　　　　　　　　　　　　  その他（　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　）"]
[]
[null,"※添付書類は、写し（コピー）でも構いません。"]