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["交通建设项目档案专项验收申请表"]
["项目名称"]
["项目审批    （核准）机关",null,"初步设计审批机关"]
["投资规模",null,"建设时间"]
["项目法人   （建设单位）",null,"设计单位"]
["  主要       施工单位",null,"主要     监理单位"]
[" 计划档案    验收日期",null,"计划竣工验收日期"]
["联系人",null,"联系电话"]
["地址／邮编",null,"电子信箱"]
["  申请单位   自检意见"]
[]
[null,null,"（单位盖章）"]
[null,null,"年    月    日"]
[" 验收组织    单位意见"]
[]
[null,null,"（单位盖章）"]
[null,null,"年    月    日"]