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<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'><span lang=3DEN-US
style=3D'font-size:13.0pt;mso-bidi-font-size:10.5pt;font-family:"MS Gothic"=
'>10</span><span
style=3D'font-size:13.0pt;mso-bidi-font-size:10.5pt;font-family:"MS Gothic"=
'>&#65293;&#65305;</span><span
style=3D'font-size:13.0pt;mso-bidi-font-size:10.5pt'>&#12288;&#27973;&#2147=
5;&#24066;&#28797;&#23475;&#32202;&#24613;&#25918;&#36865;&#12395;&#38306;&=
#12377;&#12427;&#21332;&#23450;&#26360;<span
lang=3DEN-US><o:p></o:p></span></span></p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'><span lang=3DEN-U=
S><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#27973;&=
#21475;&#24066;&#65288;&#20197;&#19979;&#12300;&#30002;&#12301;&#12392;&#12=
356;&#12358;&#12290;&#65289;&#12289;&#31520;&#23713;&#22320;&#21306;&#28040=
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&#20250;&#31038;&#65288;&#20197;&#19979;&#12300;&#19993;&#12301;&#12392;&#1=
2356;&#12358;&#12290;&#65289;&#12399;&#12289;&#27973;&#21475;&#24066;&#2879=
7;&#23475;&#32202;&#24613;&#25918;&#36865;&#12398;&#23455;&#26045;&#12395;&=
#38306;&#12375;&#12289;&#27425;&#12398;&#12392;&#12362;&#12426;&#21332;&#23=
450;&#12434;&#32224;&#32080;&#12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#65288;&=
#36259;&#26088;&#65289;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'><span style=3D'font-family:"MS Gothic";mso-ha=
nsi-font-family:
"Courier New"'>&#31532;&#65297;&#26465;</span>&#12288;&#12371;&#12398;&#213=
32;&#23450;&#12399;&#12289;&#27973;&#21475;&#24066;&#12398;&#21306;&#22495;=
&#12395;&#28797;&#23475;&#21450;&#12403;&#20107;&#25925;&#12381;&#12398;&#2=
0182;&#24066;&#27665;&#12398;&#29983;&#27963;&#12395;&#24433;&#38911;&#1243=
4;&#19982;&#12360;&#12427;&#32202;&#24613;&#20107;&#24907;&#65288;&#20197;&=
#19979;&#12300;&#28797;&#23475;&#31561;&#12301;&#12392;&#12356;&#12358;&#12=
290;&#65289;&#12364;&#30330;&#29983;&#12375;&#12383;&#22580;&#21512;&#21448=
;&#12399;&#30330;&#29983;&#12377;&#12427;&#12362;&#12381;&#12428;&#12364;&#=
12354;&#12427;&#22580;&#21512;&#12398;&#12289;&#12371;&#12428;&#12395;&#383=
06;&#12377;&#12427;&#24773;&#22577;&#65288;&#20197;&#19979;&#12300;&#28797;=
&#23475;&#24773;&#22577;&#31561;&#12301;&#12392;&#12356;&#12358;&#12290;&#6=
5289;&#12398;&#36969;&#20999;&#12394;&#25552;&#20379;&#21450;&#12403;&#2591=
8;&#36865;&#65288;&#20197;&#19979;&#12300;&#28797;&#23475;&#32202;&#24613;&=
#25918;&#36865;&#12301;&#12392;&#12356;&#12358;&#12290;&#65289;&#12395;&#38=
306;&#12375;&#12390;&#24517;&#35201;&#12394;&#20107;&#38917;&#12434;&#23450=
;&#12417;&#12427;&#12418;&#12398;&#12392;&#12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#65288;&=
#36981;&#23432;&#65289;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'><span style=3D'font-family:"MS Gothic";mso-ha=
nsi-font-family:
"Courier New"'>&#31532;&#65298;&#26465;</span>&#12288;&#30002;&#12289;&#200=
57;&#21450;&#12403;&#19993;&#12399;&#12289;&#20114;&#12356;&#12395;&#27973;=
&#21475;&#24066;&#22320;&#22495;&#38450;&#28797;&#35336;&#30011;&#31561;&#1=
2398;&#36259;&#26088;&#12434;&#36981;&#23432;&#12375;&#12289;&#24066;&#2766=
5;&#29983;&#27963;&#12398;&#23433;&#23450;&#12395;&#23492;&#19982;&#12377;&=
#12427;&#12383;&#12417;&#12289;&#36805;&#36895;&#12391;&#27491;&#30906;&#12=
394;&#28797;&#23475;&#24773;&#22577;&#31561;&#12434;&#25552;&#20379;&#12377=
;&#12427;&#12424;&#12358;&#21162;&#12417;&#12427;&#12418;&#12398;&#12392;&#=
12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#65288;&=
#32202;&#24613;&#25918;&#36865;&#12398;&#23455;&#26045;&#65289;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'><span style=3D'font-family:"MS Gothic";mso-ha=
nsi-font-family:
"Courier New"'>&#31532;&#65299;&#26465;</span>&#12288;&#28797;&#23475;&#322=
02;&#24613;&#25918;&#36865;&#12399;&#12289;&#19993;&#12364;&#31649;&#29702;=
&#12377;&#12427;&#25918;&#36865;&#35373;&#20633;&#12434;&#20351;&#29992;&#1=
2375;&#12289;&#19993;&#12364;&#20104;&#23450;&#12377;&#12427;&#25918;&#3686=
5;&#30058;&#32068;&#12395;&#20778;&#20808;&#12375;&#12390;&#34892;&#12358;&=
#12418;&#12398;&#12392;&#12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#65298;&#12288;&=
#28797;&#23475;&#32202;&#24613;&#25918;&#36865;&#12399;&#12289;&#27973;&#21=
475;&#24066;&#28797;&#23475;&#32202;&#24613;&#25918;&#36865;&#35201;&#38936=
;&#12395;&#22522;&#12389;&#12365;&#34892;&#12358;&#12418;&#12398;&#12392;&#=
12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#65288;&=
#36027;&#29992;&#36000;&#25285;&#65289;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'><span style=3D'fo=
nt-family:
"MS Gothic";mso-hansi-font-family:"Courier New"'>&#31532;&#65300;&#26465;</=
span>&#12288;&#28797;&#23475;&#32202;&#24613;&#24773;&#22577;&#20253;&#3694=
8;&#35013;&#32622;&#12398;&#35373;&#20633;&#21450;&#12403;&#20462;&#29702;&=
#12395;&#35201;&#12377;&#12427;&#36027;&#29992;&#12399;&#12289;&#21407;&#21=
063;&#12392;&#12375;&#12390;&#19993;&#12398;&#36000;&#25285;&#12392;&#12377=
;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'>&#65298;&#12288;&#19993;&#12399;&#12289;&#259=
18;&#36865;&#35373;&#20633;&#12398;&#20351;&#29992;&#26009;&#12289;&#28797;=
&#23475;&#32202;&#24613;&#25918;&#36865;&#12398;&#23455;&#26045;&#12395;&#2=
0276;&#12358;&#19993;&#12398;&#20154;&#20214;&#36027;&#12289;&#12381;&#1239=
8;&#20182;&#28797;&#23475;&#32202;&#24613;&#25918;&#36865;&#12395;&#35201;&=
#12377;&#12427;&#19968;&#20999;&#12398;&#36027;&#29992;&#12434;&#30002;&#21=
448;&#12399;&#20057;&#12395;&#23550;&#12375;&#12390;&#35531;&#27714;&#12375=
;&#12394;&#12356;&#12418;&#12398;&#12392;&#12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'>&#65299;&#12288;&#21069;&#65298;&#38917;&#123=
95;&#12363;&#12363;&#12431;&#12425;&#12378;&#12289;&#30002;&#21448;&#12399;=
&#20057;&#12364;&#32202;&#24613;&#24773;&#22577;&#20253;&#36948;&#12434;&#3=
4892;&#12358;&#19978;&#12391;&#12289;&#26032;&#12383;&#12394;&#35013;&#3262=
2;&#12434;&#23566;&#20837;&#12377;&#12427;&#24517;&#35201;&#12364;&#12354;&=
#12427;&#12392;&#35469;&#12417;&#12383;&#22580;&#21512;&#12399;&#12371;&#12=
398;&#38480;&#12426;&#12391;&#12394;&#12356;&#12290;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'>&#12288;&#12288;&#12394;&#12362;&#12289;&#123=
71;&#12398;&#22580;&#21512;&#12398;&#23566;&#20837;&#36027;&#29992;&#12398;=
&#36000;&#25285;&#12399;&#12289;&#30002;&#12289;&#20057;&#21450;&#12403;&#1=
9993;&#21332;&#35696;&#12375;&#12390;&#23450;&#12417;&#12427;&#12418;&#1239=
8;&#12392;&#12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'>&#65300;&#12288;&#19993;&#12399;&#12289;&#287=
97;&#23475;&#32202;&#24613;&#25918;&#36865;&#12398;&#23455;&#26045;&#12395;=
&#12424;&#12426;&#21516;&#26178;&#21051;&#12395;&#20104;&#23450;&#12375;&#1=
2390;&#12356;&#12383;&#24195;&#21578;&#12364;&#25918;&#36865;&#12391;&#1236=
5;&#12394;&#12363;&#12387;&#12383;&#12392;&#12365;&#12399;&#12289;&#33258;&=
#24049;&#12398;&#36012;&#20219;&#12392;&#36000;&#25285;&#12395;&#12362;&#12=
356;&#12390;&#12381;&#12398;&#35299;&#27770;&#12434;&#22259;&#12427;&#12418=
;&#12398;&#12392;&#12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#65288;&=
#21332;&#23450;&#12398;&#26399;&#38291;&#65289;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'><span style=3D'fo=
nt-family:
"MS Gothic";mso-hansi-font-family:"Courier New"'>&#31532;&#65301;&#26465;</=
span>&#12288;&#12371;&#12398;&#21332;&#23450;&#12398;&#26399;&#38291;&#1239=
9;&#12289;&#21332;&#23450;&#32224;&#32080;&#12398;&#26085;&#12363;&#12425;&=
#24179;&#25104;<span
lang=3DEN-US>19</span>&#24180;&#65299;&#26376;<span lang=3DEN-US>31</span>&=
#26085;&#12414;&#12391;&#12392;&#12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'>&#65298;&#12288;&#21332;&#23450;&#26399;&#382=
91;&#28288;&#20102;&#26085;&#12398;&#65297;&#31623;&#26376;&#21069;&#12414;=
&#12391;&#12395;&#12289;&#30002;&#12289;&#20057;&#21448;&#12399;&#19993;&#1=
2363;&#12425;&#20309;&#12425;&#12398;&#30003;&#12375;&#20986;&#12398;&#1239=
4;&#12356;&#22580;&#21512;&#12399;&#12289;&#21332;&#23450;&#26399;&#38291;&=
#12434;&#12373;&#12425;&#12395;&#65297;&#24180;&#38291;&#24310;&#38263;&#12=
377;&#12427;&#12418;&#12398;&#12392;&#12375;&#12289;&#20197;&#24460;&#12418=
;&#21516;&#27096;&#12392;&#12377;&#12427;&#12290;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#65288;&=
#12381;&#12398;&#20182;&#65289;</p>

<p class=3DMsoPlainText style=3D'margin-left:10.5pt;text-indent:-10.5pt;mso=
-char-indent-count:
-1.0;punctuation-wrap:simple'><span style=3D'font-family:"MS Gothic";mso-ha=
nsi-font-family:
"Courier New"'>&#31532;&#65302;&#26465;</span>&#12288;&#12371;&#12398;&#213=
32;&#23450;&#12395;&#23450;&#12417;&#12398;&#12394;&#12356;&#20107;&#38917;=
&#21448;&#12399;&#30097;&#32681;&#12364;&#29983;&#12376;&#12383;&#20107;&#3=
8917;&#12395;&#12388;&#12356;&#12390;&#12399;&#12289;&#24517;&#35201;&#1239=
5;&#24540;&#12376;&#12390;&#12289;&#30002;&#20057;&#19993;&#21332;&#35696;&=
#12375;&#12390;&#23450;&#12417;&#12427;&#12418;&#12398;&#12392;&#12377;&#12=
427;&#12290;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'><span lang=3DEN-U=
S><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#12371;&=
#12398;&#21332;&#23450;&#12398;&#32224;&#32080;&#12434;&#35388;&#12377;&#12=
427;&#12383;&#12417;&#12289;&#26412;&#26360;&#65299;&#36890;&#12434;&#20316=
;&#25104;&#12375;&#12289;&#30002;&#20057;&#19993;&#35352;&#21517;&#25276;&#=
21360;&#12398;&#19978;&#12289;&#21508;&#33258;&#65297;&#36890;&#12434;&#204=
45;&#26377;&#12377;&#12427;&#12418;&#12398;&#12392;&#12377;&#12427;&#12290;=
</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'><span lang=3DEN-U=
S><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'>&#12288;&#12288;&=
#24179;&#25104;<span
lang=3DEN-US>18</span>&#24180;&#65304;&#26376;<span lang=3DEN-US>18</span>&=
#26085;</p>

<p class=3DMsoPlainText style=3D'punctuation-wrap:simple'><span lang=3DEN-U=
S><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
simple;word-break:break-all'>&#30002;&#12288;&#27973;&#21475;&#24066;&#4023=
2;&#26041;&#30010;&#20845;&#26465;&#38498;&#20013;<span
lang=3DEN-US>3050</span>&#30058;&#22320;&#12288;&#12288;&#12288;&#12288;&#1=
2288;&#12288;</p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
simple;word-break:break-all'>&#27973;&#21475;&#24066;&#12288;&#12288;&#1228=
8;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;&=
#12288;&#12288;&#12288;&#12288;&#12288;</p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
simple;word-break:break-all'><span style=3D'mso-font-kerning:0pt'>&#27973;&=
#21475;&#24066;&#38263;&#12288;&#12288;&#12288;&#12288;</span>&#12288;&#300=
00;&#12288;&#20027;&#12288;&#26234;&#12288;&#24422;&#12288;&#21360;&#12288;=
&#12288;</p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
simple'><span lang=3DEN-US><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
simple;word-break:break-all'>&#20057;&#12288;&#31520;&#23713;&#24066;&#2131=
3;&#19968;&#30058;&#30010;<span
lang=3DEN-US>4</span>&#30058;&#22320;&#12398;<span lang=3DEN-US>3</span>&#1=
2288;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;</p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
simple;word-break:break-all'>&#31520;&#23713;&#22320;&#21306;&#28040;&#3845=
0;&#32068;&#21512;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;&#12288;&=
#12288;&#12288;&#12288;&#12288;&#12288;</p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
simple;word-break:break-all'>&#31649;&#29702;&#32773;&#12288;&#31520;&#2371=
3;&#24066;&#38263;&#12288;&#39640;&#12288;&#26408;&#12288;&#30452;&#12288;&=
#30690;&#12288;&#21360;&#12288;&#12288;</p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
simple'><span lang=3DEN-US><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoPlainText align=3Dright style=3D'text-align:right;punctuation=
-wrap:
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