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  • Form HPL On Street Kec

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    Egit Koeswantoro
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    1. This document outlines the results of a field inspection for a territorial patrol in an unnamed city. 2. The patrol surveyed several streets and neighborhoods, noting any construction activities, whether permits were present, and potential zoning violations. 3. The inspection team identified several issues, including construction without permits and violations of setback or height requirements. Recommendations were made for enforcement actions.

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    Form HPL on Street Kec

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    Form HPL on Street Kec

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    1. This document outlines the results of a field inspection for a territorial patrol in an unnamed city. 2. The patrol surveyed several streets and neighborhoods, noting any construction activities, whether permits were present, and potential zoning violations. 3. The inspection team identified several issues, including construction without permits and violations of setback or height requirements. Recommendations were made for enforcement actions.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    4 views3 pages

    Form HPL On Street Kec

    Uploaded by

    Egit Koeswantoro
    1. This document outlines the results of a field inspection for a territorial patrol in an unnamed city. 2. The patrol surveyed several streets and neighborhoods, noting any construction activities, whether permits were present, and potential zoning violations. 3. The inspection team identified several issues, including construction without permits and violations of setback or height requirements. Recommendations were made for enforcement actions.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    F. 02.

    01/BPB
    UNTUK PATROLI ON STREET

    HASIL PEMERIKSAAN LAPANGAN (HPL)


    Nomor :…………/HPL-PTR-K/........**/…….. ***/3/20 .... Tanggal ..................

    Data dilapangan
    1. Tanggal survey patroli : Hari …………………., ……… .............…… 20..……..
    2. Lokasi Kegiatan Patroli Teritorial:
    a. Nama Jalan : ………………………………………………………………………………….
    ………………………………………………………………………………….
    ………………………………………………………………………………….
    b. Kelurahan : ………………………………………………………………………………….
    c. Kecamatan : ………………………………………………………………………………….
    d. Kota Administrasi : ………………………………………………………………………………….
    e. Zona / Sub Zona : ………………………………………………………………………………….
    ………………………………………………………………………………….
    ………………………………………………………………………………….
    ………………………………………………………………………………….

    3. Kegiatan Membangun : Ada Tidak ada


    4. Jumlah Kegiatan Membangun : ………………………………………………………………………. Lokasi
    a. Ada izin : : ………………………………………………………………………. Lokasi
    ‐ Papan Proyek : Terpasang ................................................................................ Lokasi
    : Tidak Terpasang..…………………………………………………. Lokasi
    b. Tidak ada izin : ………………………………………………………………………. Lokasi

    5. Jumlah Indikasi Pelanggaran : ………………………………………………………………………...........


    Kegiatan Membangun: :
    a. Peruntukan / Zona / Sub : Sesuai …………………………………......………………………. Lokasi
    Zona
    Tidak Sesuai ...…………………………….………………………. Lokasi
    b. Jarak Bebas (GSB, GSJ, : Sesuai …………………………………......………………………. Lokasi
    Ketinggian Bangunan dll)
    Tidak Sesuai ...…………………………….………………………. Lokasi
    6. Usulan Tindakan Penertiban : ………………………………………………………………………...........
    ………………………………………………………………………...........

    7. Catatan Hasil Pemeriksaan : ………………………………………………………………………...........


    ………………………………………………………………………...........
    ………………………………………………………………………………….
    ………………………………………………………………………...........
    ………………………………………………………………………...........
    ………………………………………………………………………………….
    ………………………………………………………………………...........
    ………………………………………………………………………...........
    Petugas lapangan Tanda tangan Verifikasi

    1. Sahmad …………………………………
    2. Egit Koeswantoro ………………………………...
    3. Meidyastuti ………………………………... Bambang Widyanto, ST
    4. Iswadi ………………………………... NIP. 197306082009041001

    5. Tambi Septono .………………………………..

    Keterangan: ** Wilayah (JP, JU, JB, JS, JT) ; *** Singkatan Kecamatan terdiri dari 3 (tiga) huruf
    F. 02.01/BPB
    UNTUK PATROLI ON STREET

    Lampiran Tambahan

    - Foto kondisi lapangan


    - Foto kondisi sekitar bangunan
    F. 02.01/BPB
    UNTUK PATROLI ON STREET

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