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["汇金砂业居民用砂申请表"]
[]
["房屋地址"]
["房屋所有权人",null,null,"房屋建筑面积",null,"提砂方式","配送"]
["购砂人",null,null,"购砂人联系方式"]
["购砂人身份证号"]
["装修/自建房用砂总量（吨）",null,"申请用砂量\n(吨)",null,"砂石用途"]
[]
["确认","购砂人签字：                      物业（村委会）盖章：                                     日      期：                      日      期："]
["注：\n1.此表为居民申购散装河砂所用； \n2.扫描右下方二维码，实名注册后申购河砂；\n3.上传资料包括：《汇金砂业居民用砂申请表》、建房                        相关证明资料、购砂人身份证、用砂房屋现场照片等；\n4.相同的购砂证明材料和购砂联系人手机号码一年内只                        能申购一次；\n5.咨询电话：0797-8160153；"]