On the approval of the form and composition of the information of the inspection report, as well as the requirements for its preparation. Appendix B.4. Report on the survey of the social infrastructure facility to the axis accessibility certificate Act on the survey of accessibility for the disabled in the preschool educational institution

APPROVED

Chairman of the Commission

ACT OF INSPECTION

TO ACCESS PASSPORT

Municipal budgetary educational institution secondary school No. 2 of the urban settlement "Workers' village Vanino" of the Vaninsky municipal district of the Khabarovsk Territory

1. General information about the object

1.1. Name (type) of the object: Municipal budgetary educational institution, secondary school No. 2 of the urban settlement "Vanino Workers' Village" of Vaninsky municipal district Khabarovsk Territory

1.2. Address of the object: 682860, Russia, Khabarovsk Territory, Vaninsky district, Vanino, Oktyabrskaya street, 3

1.3. Information about the location of the object: a detached building, consisting of 2 floors, with a total area 1837, 7 sq. m... The presence of an adjacent land plot - 11991 sq. m.

1.4. Year of construction of the building - 1953, a detached building, consisting of 2 floors, with a total area 1837, 7 sq. m. The presence of an adjacent land plot - 11991 sq. m.

1.5. Date of upcoming scheduled repairs: current repairs 2016-2017

1.6. The name of the organization (institution), (full legal name - according to the Charter, short name): - Municipal budgetary educational institution, secondary school No. 2 of the urban settlement "Vanino Workers' Settlement" of the Vaninsky Municipal District of the Khabarovsk Territory; short name: MBOU Secondary School No. 2, item Vanino

1.7. Legal address of the organization (institution): 682860, Khabarovsk Territory, Vaninsky district, Vanino, st. October ,. Tel /;

2. Characteristics of the organization's activities at the facility

(Additional Information)

2.1 Scope of activity: education

2.2 Types of services provided: organization of the provision and provision of public and free primary general, basic, secondary general education and additional education; organization of recreation for children during vacation time

2.3 Service provision form: at the facility, at home, remotely

2.5 Categories of disabled people served: disabled people moving in a wheelchair; disabled people with musculoskeletal disorders; visual impairment; hearing impairment; mental disorders.

2.6 Planned capacity: attendance (number served per day), capacity, throughput - 293 people, / 275 people, / 300 people.

2.7 Participation in the performance of the IPR of a disabled person, a disabled child: Yes

3. The state of accessibility of the facility for the disabled

and other people with limited mobility

from the territory adjacent to the building.

3.1 Route to the object by passenger transport

Access to the facility can be carried out by public transport: bus number 12, 15, 103; taxi and private vehicles

There is no adapted passenger transport to the facility.

3.2 The way to the object from the nearest stop of passenger transport:

3.2.1 distance to the object from the transport stop 100 m

3.2.2 travel time (on foot) no more than 5 minutes

3.2.3 the presence of a pedestrian path separated from the carriageway (Yes , No),

3.2.4 Intersections: unregulated; adjustable, with sound signaling,

timer;No

3.2.5 Information on the route to the object: acoustic, tactile,

visual ; No

3.2.6 Differences in height on the way: there are up to 150 mm (at the entrance to the gate)

Their arrangement for wheelchair users: Yes , No (decrease in altitude

the border of the pedestrian part for passage or passage in a wheelchair)

3.3 The option of organizing the availability of a social infrastructure object (service form), taking into account SP 35-101-2001

* - one of the options is indicated: "A" ( an object where the requirements of the current regulatory documents in the field of design and construction have been met for all functional areas and all accessibility criteria) , "B" ( an object where the requirements of the current standards for the main functional zones are met, which ensure the achievement of the places of the target visit to the building (object). At the same time, an acceptable option is the organization of a dedicated path and service points, special areas for servicing low-mobility groups of the population) , "DU" ( After the execution of an organizational decision on an alternative form of service (when providing access with the help of an unauthorized person, including an employee of the institution, or in another way: remotely, at home, in another institution, at another facility of this institution, etc.), the object is recognized conditionally accessible... The same decision can be made in the case of identifying the parameters of structural and functional elements at the facility (for example, the slope of the ramp at the entrance, longitudinal or lateral slope on the way, etc.) that do not meet the requirements of SNiP and SP, which, after agreement with the consumer (with public organizations of disabled people), can be accepted as acceptable.) , "VND" ( in case of non-compliance with the requirements of regulatory documents in the field of design and construction (accessibility requirements) for MGN, the object must be recognized temporarily unavailable- before making a decision on the arrangement and its implementation, or before organizing an alternative form of service for people with limited mobility)

3.4 The state of accessibility of the main structural and functional areas

Main structural and functional areas

Availability state,

including for the main categories of disabled people **

Appendix

No. on the plan

Entrance (s) to the building

№ 5.2, № 6, №7.1,

Target area of ​​the building (target visit to the site)

Information and communication system (in all zones)

** Indicated: DP-V- fully available to everyone; DP-I(K, O, S, G, U) - fully selectively available (indicate the categories of disabled people); DCh-V- partially available to everyone; DCh-I(K, O, S, G, U) - available partially selectively (indicate the categories of disabled people); DU- available conditionally, GNI- not available

3.5. FINAL CONCLUSION on the state of accessibility of the social infrastructure facility : Object for disabled people with visual impairment, hearing impairment, wheelchair access is conditionally available. For the purpose of full access, it is necessary to carry out repairs: current, major repairs (entrance to the building, sanitary and hygienic premises), the acquisition of technical means of adaptation for individual service.

4. Management decision(project)

The main structural and functional areas of the object

The area adjacent to the building (site)

Does not need

Entrance (s) to the building

Maintenance

Route (s) of movement inside the building (including escape routes)

Individual solution with ТСР

Target area (targeted site visit)

Individual solution with ТСР

Sanitary and hygienic premises

Major repairs

Site information system (in all zones)

Individual solution with ТСР

Traffic routes to the object (from the transport stop)

Maintenance

All zones and areas

In need of repair: current, major, with an individual solution with TSR

* - one of the options (types of work) is indicated: does not need; repair (current, overhaul); individual solution with ТСР; technical solutions are not possible - the organization of an alternative form of service. Filled in based on the description of the accessibility parameters.

MINISTRY OF ECONOMIC DEVELOPMENT OF THE RUSSIAN FEDERATION

ORDER

On the approval of the form and composition of the information of the survey report, as well as the requirements for its preparation


Document with changes made:
(The official Internet portal of legal information www.pravo.gov.ru, 19.12.2016, N 0001201612190056) (entered into force on January 1, 2017);
(Official Internet portal of legal information www.pravo.gov.ru, 09.07.2019, N 0001201907090014);
(The official Internet portal of legal information www.pravo.gov.ru, 30.12.2019, N 0001201912300053).
____________________________________________________________________


In accordance with part 3 of article 23 of the Federal law of July 13, 2015 N 218-FZ "On state registration of real estate" (Collection of laws Russian Federation, 2015, N 29, Art.4344), paragraph 1 and subparagraph 5.2.29 of the Regulation on the Ministry of Economic Development of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 5, 2008 N 437 (Collected Legislation of the Russian Federation, 2008, N 24, Art. .2867; N 46, Art. 5337; 2009, N 3, Art. 378; N 18, Art. 2257; N 19, Art. 2344; N 25, Art. 3052; N 26, Art. 3190; N 41, Art.4777; N 46, Art.5488; 2010, N 5, Art.532; N 9, Art.960; N 10, Art.1085; N 19, Art.2324; N 21, Art.2602; N 26 , art. 3350; N 40, art. 5068; N 41, art. 5240; N 45, art. 5860; N 52, art. 7104; 2011, N 9, art. 1251; N 12, art. 1640; N 14, Art. 1935; N 15, Art. 2131; N 17, Art. 2411, 2424; N 32, Art. 4834; N 36, Art. 5149, 5151; N 39, Art. 5485; N 43, Art. 6079; N 46, Art. 6527; 2012, N 1, Art. 170, 177; N 13, Art. 1531; N 19, Art. 2436, 2444; N 27, Art. 3745, 3766; N 37, Art. 5001; N 39, Art. 5284; N 51, Art. 7236; N 52, Art. 7491; N 53, Art. 7943; 2013, N 5, Art. 391; N 14, Art. 1705; N 33, Art. .4386; N 35, Art. 4514; N 36, Art. 4578; N 45, Art. 5822; N 47, Art. 6120; N 50, Article 6606; 52, Article 7217; 2014, No. 6, article 584; 15, Article 1750; 16, Article 1900; 21, Article 2712; 37, Article 4954; 40, Article 5426; 42, Article 5757; No. 44, art. 6072; 48, Article 6871; 49, Article 6957; No. 50, Art. 7100, 7123; 51, Article 7446; 2015, No. 1, article 219; No. 6, Article 965; 7, Article 1046; No. 16, Article 2388; No. 20, Article 2920; 22, Article 3230; No. 24, Article 3479; 30, Article 4589; 36, Article 5050; 41, Article 5671; 43, Article 5977; 44, Article 6140; official Internet portal of legal information pravo.gov.ru, 11/10/2015, 11/11/2015),

I order:

1. To approve:

1) the form and composition of the information of the inspection report (Appendix N 1);

2) requirements for the preparation of the survey report (Appendix N 2).

2. To establish that before July 1, 2017, for the implementation of state cadastral registration, inspection reports can be submitted, prepared in the final version in accordance with the requirements for the preparation of the inspection report, in force before the entry into force of this order, and signed with a strengthened qualified electronic signature of the cadastral engineer before January 1, 2017.
(The item is additionally included from January 1, 2017 of November 23, 2016 N 742)
____________________________________________________________________
Clause 2 of the previous edition from January 1, 2017 is considered clause 3 of this edition -.

____________________________________________________________________

Acting Minister
N.R. Podguzov

Registered
at the Ministry of Justice
Russian Federation
December 25, 2015
registration N 40274

Appendix N 1. Form and composition of information of the survey report

Appendix N 1
to order
Ministry of Economic Development of Russia
dated November 20, 2015 N 861
(As amended by
from January 1, 2017
by order of the Ministry of Economic Development of Russia
dated November 23, 2016 N 742;
as amended
from January 10, 2020
by order of the Ministry of Economic Development of Russia
dated September 25, 2019 N 592. -
See previous edition)

The form and composition of the information of the inspection report

ACT OF INSPECTION

1. The inspection report was prepared as a result of cadastral work in order to submit to the registration authority an application for deregistration of a building, structure, parking space, construction in progress ( the required is indicated) with cadastral N ________________, rights to which registered, not registered ( the required is indicated) in the Unified State Register of Real Estate

2. Information about the customer of cadastral works:

(last name, first name, patronymic (last name - if any) of an individual, insurance number of an individual personal account (if any), full name legal entity, public authority, local government, foreign legal entity indicating the country of its registration (incorporation)

3. Information about the cadastral engineer and the date of preparation of the survey report:

Surname, name, patronymic (last name - if any) _______________________________________

Unique registration number of a member of a self-regulatory organization of cadastral engineers in the register of members of a self-regulatory organization of cadastral engineers and the date of entering information about an individual in such a register ___________________________________________________________

Insurance number of an individual personal account in the compulsory pension insurance system of the Russian Federation (SNILS) ___________________________________________________________

Contact number ___________________________________________________________________

Postal address and address Email through which communication with the cadastral engineer is carried out ____________________________________________________________________________

The name of the self-regulatory organization of cadastral engineers, of which the cadastral engineer is a member ____________________________________________________________________

Full or (if available) abbreviated name of the legal entity, if the cadastral engineer is an employee of the legal entity, the address of the legal entity is __________

Name, number and date of the document on the basis of which the cadastral work is carried out
__________________________________________________________________________________

Date of preparation of the survey report (day, month, year) ______________________________________

4. List of documents used in the preparation of the survey report
(name and details of the document)

5. Conclusion of the cadastral engineer

Appendix N 2. Requirements for the preparation of the survey report

1. Requirements for the preparation of a survey report (hereinafter referred to as the Requirements) establish the rules for drawing up a survey report (hereinafter referred to as the Act).

2. In accordance with the Federal Law of July 13, 2015 N 218-FZ "On state registration of real estate" (hereinafter - the Law), the Act is a document in which the cadastral engineer, as a result of the inspection of the location of the building, structure, premises, parking lot or an object of construction in progress, taking into account the available information from the Unified State Register of Real Estate about such an object of real estate, confirms the termination of the existence of a building, structure, an object of construction in progress in connection with the death or destruction of such a property, or the termination of the existence of a premises, a parking lot in connection with the death or destruction of a building or a structure in which a room, a parking lot was located, by the destruction or destruction of a part of a building or a structure, within which such a room, a parking space was located.
(Clause as amended, entered into force on January 1, 2017 by order of the Ministry of Economic Development of Russia dated November 23, 2016 N 742.
________________
Collected Legislation of the Russian Federation, 2015, N 29, Art.4344; 2016, No. 1, article 51; No. 18, Articles 2484, 2495; 23, Article 3296; No. 26, Article 3890; 27, Articles 4198, 4237, 4248, 4284, 4287, 4294.
(Footnote as amended, entered into force on January 1, 2017 by order of the Ministry of Economic Development of Russia dated November 23, 2016 N 742.

3. The act is prepared on the basis of information obtained as a result of inspection of the location of the real estate object, taking into account the information of the Unified State Register of Real Estate, as well as other documents confirming the termination of the existence of the real estate object or being the basis for the demolition of the real estate object. These documents, with the exception of documents containing information from the Unified State Register of Real Estate, are included in the annex to the Act (hereinafter referred to as the Appendix).

If the relevant documents are not included in the Appendix, the reason for their non-use must be given in the line "Conclusion of the cadastral engineer".

4. All entries, with the exception of cases established by law, are made in the Act in Russian. Numbers are written in Arabic numerals.

5. The Act includes the following information: about the real estate object in respect of which cadastral work is being carried out, about the customer of the cadastral work, about the cadastral engineer and the date of preparation of the Act, about the documents used in the preparation of the Act.

6. The requisite "Information about the real estate object in respect of which cadastral work is being carried out" contains information about the type of the real estate object and its cadastral number, as well as information about the presence (absence) of information on registered rights to the real estate object in the Unified State Register of Real Estate.

7. The requisite "Information about the customer of cadastral works" contains information about the customer of cadastral works:

in relation to an individual - last name, first name, patronymic (the latter - if any), insurance number of an individual personal account (if any);

in relation to a legal entity, government body, local government body, foreign legal entity - full name. In relation to a foreign legal entity, the country of registration (incorporation) is additionally indicated.

8. The requisite "Information about the cadastral engineer and the date of preparation of the inspection report" contains the following information:

1) surname, first name, patronymic (the latter - if any) of the cadastral engineer;

2) a unique registration number of a member of a self-regulatory organization of cadastral engineers in the register of members of a self-regulatory organization of cadastral engineers and the date of entering information about an individual in such a register;
by order of the Ministry of Economic Development of Russia dated September 25, 2019 N 592.

3) insurance number of an individual personal account in the compulsory pension insurance system of the Russian Federation (SNILS);
(The subparagraph is additionally included from January 1, 2017 by order of the Ministry of Economic Development of Russia dated November 23, 2016 N 742)
____________________________________________________________________
Subparagraphs 3, 4, 5, 6, 7, 8 of the previous edition from January 1, 2017 are considered subparagraphs 4, 5, 6, 7, 8, 9 of this edition respectively - order of the Ministry of Economic Development of Russia dated November 23, 2016 N 742.

____________________________________________________________________

4) contact phone number of the cadastral engineer;

5) the postal address and e-mail address used to communicate with the cadastral engineer;

6) the name of the self-regulatory organization of cadastral engineers, of which the cadastral engineer is a member;
by order of the Ministry of Economic Development of Russia of November 23, 2016 N 742.

7) full or (if any) abbreviated name of the legal entity, if the cadastral engineer is an employee of the legal entity, the address of the location of the legal entity;
(Subclause as amended, entered into force on January 10, 2020 by order of the Ministry of Economic Development of Russia dated September 25, 2019 N 592.

8) the name, number and date of the document on the basis of which the cadastral work is carried out;
(Subclause as amended, entered into force on January 10, 2020 by order of the Ministry of Economic Development of Russia dated September 25, 2019 N 592.

9) the date of preparation of the final version of the Act by the cadastral engineer (date of completion of cadastral work) in the format of day, month, year, number and date of the document on the basis of which the cadastral work is performed.
(Subclause as amended, entered into force on January 10, 2020 by order of the Ministry of Economic Development of Russia dated September 25, 2019 N 592.

9. The requisite "List of documents used in the preparation of the survey report" contains information about the name and details of the documents used in the preparation of the Act, including the following:

1) decisions of the executive authority of the constituent entity of the Russian Federation, or municipality on the recognition of the property as emergency and subject to demolition in the manner prescribed by law; a document confirming the seizure for state or municipal needs of a land plot with real estate objects located on this land plot to be demolished; a document confirming the development of the built-up area where the property subject to demolition is located; other documents on the basis of which a decision was made to carry out the demolition (dismantling) in the event of the compulsory withdrawal of the property from the owner;
by order of the Ministry of Economic Development of Russia of March 26, 2019 N 166.

1.1) demolition decisions unauthorized construction either a decision on the demolition of an unauthorized building or its bringing in accordance with the established requirements, adopted by the local government of the settlement, urban district at the location of the unauthorized building or, if the unauthorized building is located in the inter-settlement area, by the local government of the municipal district;
by order of the Ministry of Economic Development of Russia dated March 26, 2019 N 166)

1.2) a decision to demolish a capital construction object independently, made by the owner of the capital construction object or the owners of the premises in it (prepared in arbitrary writing and signed by such owner (owners), notarization of such a decision is not required), in connection with the establishment of a zone with special conditions use of the territory or the conclusion of an agreement on compensation for losses caused by the restriction of the rights of the indicated owner of the capital construction object or owners of premises in it in connection with the establishment of a zone with special conditions for the use of the territory;
(The subparagraph is additionally included from July 20, 2019 by order of the Ministry of Economic Development of Russia dated March 26, 2019 N 166)

1.3) a court decision on the demolition of an unauthorized building or a court decision on the demolition of a capital construction object, adopted in connection with the failure to reach an agreement on compensation for losses during the demolition of a capital construction object in connection with the establishment of a zone with special conditions for the use of the territory;
(The subparagraph is additionally included from July 20, 2019 by order of the Ministry of Economic Development of Russia dated March 26, 2019 N 166)

2) design documentation of the capital construction object (with the exception of project documentation linear objects) in case of demolition or dismantling of a capital construction object, its parts for construction, reconstruction of other capital construction objects;

3) the decision of the owner of a building, structure, object of construction in progress (owners of premises in it) on the demolition of the real estate object (prepared in arbitrary writing and signed by such owners, notarization of such a decision is not required) in case of voluntary demolition of the object outside of connection with the establishment of a zone with special conditions for the use of the territory;
(Subparagraph as amended, entered into force on July 20, 2019 by order of the Ministry of Economic Development of Russia dated March 26, 2019 N 166.

4) documents of the executive authority of a constituent entity of the Russian Federation or a municipality, confirming the fact of natural disasters or other emergencies in the event of the termination of the existence of a building, structure, object of unfinished construction in connection with the destruction of such a property or the termination of the existence of a premise, parking space in connection with the destruction of the building or structure in which the premises, parking space was located, the destruction of a part of the building or structure, within which such premises, parking spaces were located, for reasons beyond the control of the owner of such real estate object;
(Subparagraph as amended, entered into force on January 1, 2017 by order of the Ministry of Economic Development of Russia dated November 23, 2016 N 742.

5) other documents established by legislative and other regulatory legal acts of the Russian Federation.

Copies of documents containing information from the Unified State Register of Real Estate are not included in the Appendix.

If the capital construction object ceased to exist after August 4, 2018 as a result of its demolition, information on the notification of the completion of the demolition of the capital construction object and on sending such a notification to the local authority is also entered in the "List of documents used in the preparation of the survey report" self-government of a settlement, urban district or municipal district at the location of the land plot on which the demolished capital construction object was located.
(The paragraph is additionally included from July 20, 2019 by order of the Ministry of Economic Development of Russia of March 26, 2019 N 166)

10. The requisite "Conclusion of the cadastral engineer" in the form of a coherent text contains the conclusion of the cadastral engineer on the termination of the existence of the property.

11. The act is prepared in the form of an electronic document in the form of an XML document, certified by a strengthened qualified electronic signature of the cadastral engineer who prepared such a plan, and is drawn up in the form of files in XML format (hereinafter - XML ​​document), created using XML schemas and providing reading and control of the presented data.

The composition of the information of the Act in the form of an electronic document must correspond to the composition of the information contained in the approved form of the Act, taking into account the Requirements.

12. XML-schemas used to generate XML-documents are considered to be put into effect after two months from the date of their posting on the official website of the Federal Service state registration, cadastre and cartography in the information and telecommunication network "Internet" at the address: www.rosreestr.ru (hereinafter - the official site).

When changing the regulatory legal acts that establish the form and requirements for the preparation of the Act, the Federal Service for State Registration, Cadastre and Cartography changes the formats of XML documents and XML schemas, while providing on the official website the possibility of public access to the current current version and previous (no longer relevant ) versions.

Means of an enhanced qualified electronic signature of a cadastral engineer must be certified in accordance with the legislation of the Russian Federation and are compatible with the means of a qualified electronic signature used by the Federal Service for State Registration, Cadastre and Cartography, and its territorial bodies.

Information on the requirements for compatibility, the signature key certificate, ensuring the possibility of confirming the authenticity of the enhanced qualified electronic signature of the cadastral engineer is posted on the official website.

13. Documents prepared on paper, which, in accordance with the Requirements, are to be included in the Appendix, are issued in the form of electronic images of paper documents in the form of PDF files signed with an enhanced qualified electronic signature of the cadastral engineer who prepared the Act.

The electronic image of the document must provide visual identity to its paper original on a 1: 1 scale. The quality of the presented electronic images of documents should allow you to fully read the text of the document and recognize its details. If a paper document consists of two or more sheets, the electronic image of such a paper document is formed in the form of one file. To scan documents, you must use monochrome mode with a resolution of 300 dpi.

If the legislation allows the preparation of a document to be included in the Appendix in the form of an electronic document, such a document may be included in the Appendix in the form of an electronic document.

An electronic document to be included in the Appendix, issued by a public authority, local government body, organization, is certified with an enhanced qualified electronic signature of an authorized official of such a public authority, local government body, organization, and an electronic document prepared by an individual is certified by an enhanced qualified electronic signature. by the signature of such an individual.

14. The act is also prepared in the form of a paper document, if it is provided for by the work contract. The act, prepared in the form of a paper document, is certified by the signature and seal of the cadastral engineer who prepared such an Act. Unfilled details of the Act in the form of a document on paper are not excluded, in such details the sign "-" (dash) is put down.

Document revision taking into account
changes and additions prepared
JSC "Codex"

1.4. Year of construction of the building _________, last major overhaul ______________

1.5. Date of upcoming scheduled renovation works: current ________, capital _________

1.6. Name of organization (institution), (full legal name - according to the Charter, short name) _____________________________________

1.7. Legal address of the organization (institution) ________________________

2. Characteristics of the organization's activities at the facility

Additional Information _____________________________________________________

3. Object availability state

3.1 Route to the object by passenger transport (describe the route using passenger transport)

Availability of adapted passenger transport to the facility _______________________

3.2 The way to the object from the nearest stop of passenger transport:

3.2.1 distance to the object from the transport stop ________________ m

3.2.2 driving time (on foot) ___________________ min

3.2.3 the presence of a pedestrian path separated from the carriageway (yes, no),

3.2.4 Intersections: unregulated; adjustable, with sound signaling, timer; No

3.2.5 Information on the way to the object: acoustic, tactile, visual; No

3.2.6 Differences in height on the way: yes, no (describe by ______________________________________)

Their arrangement for wheelchair users: yes, no (__________________________)

3.3 Organization of accessibility of the facility for the disabled - service form

Option for organizing the availability of an object
(service forms)

including disabled people:

wheelchair users

with disorders of the musculoskeletal system

visually impaired

hearing impaired

with intellectual disabilities

Appendix

N on plan

Entrance (s) to the building

Information and communication system (in all zones)

The area adjacent to the building (site)

Entrance (s) to the building

Route (s) of movement inside the building (including escape routes)

Target area of ​​the building (target visit to the site)

Sanitary and hygienic premises

Site information system (in all zones)

Traffic routes to the object (from the transport stop)

All zones and areas

______________________________

* - one of the options (types of work) is indicated: does not need; repair (current, overhaul); individual solution with ТСР; technical solutions are not possible - organization of an alternative form of service

4.2. Period of work ______________________________________ within the framework of execution _____________________________________________________ (the name of the document is indicated: program, plan) 4.3 Expected result (according to the state of availability) after completion of work on adaptation ______________________________________________________ Assessment of the result of execution of the program, plan (according to the state of availability) ______________ 4.4. To make a decision, it is required, not required (underline the necessary): 4.4.1. approval by the Commission ___________________________________ _________________________________________________________________________ (name of the Commission for the coordination of activities in the field of providing an accessible living environment for people with disabilities and other MGN) 4.4.2. coordination of work with supervisory authorities (in the field of design and construction, architecture, protection of monuments, other - specify) ________________________________________________________________ 4.4.3. technical expertise; development of design and estimate documentation; 4.4.4. coordination with a superior organization (owner of the object); 4.4.5. coordination with public organizations of disabled people _______ __________________; 4.4.6. other _____________________________________________________ There is a conclusion of the authorized organization on the status of the object's availability (name of the document and the issuing organization, date), attached _____________________________________________________________ 4.7. Information can be placed (updated) on the Accessibility Map of the constituent entity of the Russian Federation _______________________________ _________________________________________________________________________ (name of the site, portal)

5. Special marks

APPLICATIONS:

Survey results:

1. The territory adjacent to the object on __________ l.

2. Entrance (entrances) to the building on __________ l.

3. Tracks of movement in the building on __________ l.

4. Zones of purpose of the object on __________ l.

5. Sanitary and hygienic premises for __________ l.

6. Information (and communication) systems at the facility on __________ l.

Photo fixation results at the object __________________ on __________ sheets.

Floor plans, BTI passport _______________________ on __________ sheets.

Other (including additional information about the paths to the object)

___________________________________________________________________

___________________________________________________________________

Head of the working group ___________________________________________ ______________ (Position, full name) (Signature) Members of the working group: ___________________________________________ ______________ (Position, full name) (Signature) ___________________________________________ ______________ (Position, full name) ( Signature) Including: representatives of public organizations of persons with disabilities ___________________________________________ ______________ (Position, full name) (Signature) ___________________________________________ ______________ (Position, full name) (Signature) representatives of the organization located at the facility ___________________________________________ ______________ (Position , Full name) (Signature) ___________________________________________ ______________ (Position, full name) (Signature) The managerial decision was approved by "____" ______________________ 20___ (protocol N _____) Commission (name) _________________________________ __________________________________________ _______________________________

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