TENTANG PENETAPAN STANDAR PELAYANAN PERIZINAN …dpmptsp.boyolali.go.id/upload/download... · 2003 tentang Retribusi Pembenan Izin Usaha Rumah Makan dan Waruiig ... Izin Peruntukan

K E P U T U S A N K E P A L A D I N A S P E N A N A M A N M O D A L

D A N P E L A Y A N A N T E R P A D U S A T U P I N T U

K A B U P A T E N B O Y O L A L I

N O M O R 5 0 3 / 1 0 7 T A H U N 2 0 1 8

T E N T A N G

P E N E T A P A N S T A N D A R P E L A Y A N A N P E R I Z I N A N

D A N N O N P E R I Z I N A N P A D A D I N A S P E N A N A M A N

M O D A L D A N P E L A Y A N A N T E R P A D U S A T U P I N T U

D P M P T S P

K A B U P A T E N B O Y O L A L I

P E M E R I N T A H K A B U P A T E N B O V O L A L I zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

D I N A S P E N A N A M A N M O D A L

D A N P E L A Y A N A N T E R P A D U S A T U

K E P U T U S A N K E P A L A D I N A S P E N A N A M A N M O D A L D A N P E L A Y A N A N

T E R P A D U S A T U P I N T U K A B U P A T E N B O Y O L A L I

N O M O R 5 0 3 / 1 0 7 T A H U N 2 0 1 8

T E N T A N G

P E N E T A P A N S T A N D A R P E L A Y A N A N P E R I Z I N A N D A N N O N P E R I Z I N A N

P A D A D I N A S P E N A N A M A N M O D A L D A N P E L A Y A N A N T E R P A D U S A T U P I N T U

K E P A L A D I N A S P E N A N A M A N M O D A L D A N P E L A Y A N A N T E R P A D U S A T U P I N T U

K A B U P A T E N B O Y O L A L I ,

M e n i m b a n g : a . b a h w a p e n e t a p a n s t a n d a r p e l a y a n a n P e r i z i n a n d a n N o n

P e r i z i n a n s e b a g a i m a n a d i t e t a p k a n d e n g a n K e p u t u s a n

K e p a l a D i n a s P e n a n a m a n M o d a l d a n P e l a y a n a n T e r p a d u

S a m P i n t u K a b u p a t e n B o y o l a l i N o m o r 5 0 3 / 4 4 1 1 T a h u n

2 0 1 7 d a l a m i m p l e m e n t a s i n y a t i d a k d a p a l d i l a k s a n a k a n

s e s u a i d e n g a n j a n g k a w a k t u y a n g l e l a h d i t e t a p k a n . k a r e n a

t i d a k m e m p e r h i l u n g k a n d e n g a n j a n g k a w a k t u p e m b e n a n

R e k o m e n d a s i d a n D i n a s T e k n i s s e b a g a r m a n a d i a i u r d a l a m

P e r a t u r a n B u p a t i N o m o r 1 0 T a h u n 2 0 1 3 t e n t a n g P e t u n j u k

P e l a k s a n a a n P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r

4 T a h u n 2 0 1 2 t e n t a n g P e l a y a n a n P e r i z i n a n d a n N o n

P e r i z i n a n s e h i n g g a d a p a t m e n g a k i b a t k a n a d a n y a

k e t i d a k p a s t i a n d a l a m j a n g k a w a k t u p e m b e n a n i z i n k e p a d a

p e m o h o n m a u p u n m c m p e n g a r u h i c a p a i a n k i n e r j a

p e i a k s a n a d i b i d a n g p e l a y a n a n p e r i z i n a n d a n n o n

p e r i z i n a n ;

b , b a h w a s e h u b u n g a n d e n g a n h a l t e r s e b u t d i a t a s m a k a

d i p a n d a n g p e r l u m e n g a t u r k e m b a l i p e n e t a p a n S i a n d a r

P e l a y a n a n P e n z m a n d a n N o n P e r i z i n a n p a d a D i n a s

P e n a n a m a n M o d a l d a n P e l a y a n a n T e r p a d u S a t u P i n t u

y a n g d i t e l a p k a n d e n g a n K e p u t u s a n K e p a l a D i n a s

P e n a n a m a n M o d a l d a n P e l a y a n a n T e r p a d u S a t u P i n t u .

M e n g i n g a t : 1 , U n d a n g - U n d a n g N o m o r 1 3 T a h u n 1 9 5 0 t e n t a n g

P e m b e n t u k a n D a e r a h - D a e r a h K a b u p a t e n D a l a m

L i n g k u n g a n P r o p i n s i D j a w a T e n g a h ( B e r i t a N e g a r a

R e p u b l i k I n d o n e s i a T a h u n 1 9 5 0 N o m o r 4 2 ) ;

2 . U n d a n g - U n d a n g N o m o r 3 T a h u n 1 9 8 2 t e n t a n g W a j i b

D a f t a r P e r u s a h a a n ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a

T a h u n 1 9 8 2 N o m o r 7 , T a m b a h a n L e m b a r a n N e g a r a

R e p u b l i k I n d o n e s i a N o m o r 3 2 1 4 ) ;

3 . U n d a n g - U n d a n g .

3 , U n d a n g - U n d a n g N o m o r 2 5 T a h u n 2 0 0 7 t e n t a n g

P e n a n a m a n M o d a l ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a

T a h u n 2 0 0 7 N o m o r 6 7 , T a m b a h a n L e m b a r a n N e g a r a

R e p u b l i k I n d o n e s i a N o m o r 4 7 2 4 } ;

4 . U n d a n g - U n d a n g N o m o r 4 0 T a h u n 2 0 0 7 t e n t a n g P e r s c r o a n

T e r b a t a s ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n

2 0 0 7 N o m o r 1 0 6 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k

I n d o n e s i a N o m o r 4 7 5 6 | ;

5 , U n d a n g - U n d a n g N o m o r 1 4 T a h u n 2 0 0 8 t e n t a n g

K c t e r b u k a a n I n f o r m a s i P u b l i k ( U - m b a r a n N e g a r a R e p u b l i k

I n d o n e s i a T a h u n 2 0 0 8 N o m o r 6 1 . T a m b a h a n L e m b a r a n

N e g a r a R e p u b l i k I n d o n e s i a N o m o r 4 8 4 6 ) ;

6 . U n d a n g - U n d a n g N o m o r 2 0 T a h u n 2 0 0 8 t e n t a n g U s a h a

M i k r o , K e c i l d a n M e n e n g a h ( L e m b a r a n N e g a r a R e p u b l i k

I n d o n e s i a T a h u n 2 0 0 8 N o m o r 9 3 , T a m b a h a n L e m b a r a n

N e g a r a R e p u b l i k I n d o n e s i a N o m o r 4 8 6 6 ) ; zywvutsrponmlkjihgfedcbaTSRPKJGA

1. U n d a n g - U n d a n g N o m o r 2 5 T a h u n 2 0 0 9 t e n l a n g P e l a y a n a n

P u b l i k ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 0 9

N o m o r 1 1 2 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k

I n d o n e s i a N o m o r 5 0 3 8 ) ;

8 . U n d a n g - U n d a n g N o m o r 7 T a h u n 2 0 1 4 t e n l a n g

P e r d a g a n g a n ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n

2 0 0 9 N o m o r 1 1 2 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k

I n d o n e s i a N o m o r 5 0 3 8 ) ;

9 . U n d a n g - U n d a n g N o m o r 2 3 T a h u n 2 0 1 4 t e n l a n g

P e m e r i n t a b a n D a e r a h ( L e m b a r a n N e g a r a R e p u b l i k

I n d o n e s i a T a h u n 2 0 1 4 N o m o r 2 4 4 , T a m b a h a n L e m b a r a n

N e g a r a R e p u b l i k I n d o n e s i a N o m o r 5 5 8 7 ) s e b a g a i m a n a

l e l a h d i u b a h b e b e r a p a k a l i t e r a k h i r d e n g a n U n d a n g -

U n d a n g N o m o r 9 T a h u n 2 0 1 5 t e n t a n g P e r u b a h a n K e d u a

A t a s U n d a n g - U n d a n g N o m o r 2 3 T a h u n 2 0 1 4 t e n t a n g

P e m e r i n t a h a n D a e r a h ( L e m b a r a n N e g a r a R e p u b l i k

I n d o n e s i a T a h u n 2 0 1 5 N o m o r 5 8 , T a m b a h a n L e m b a r a n


1 0 . P e r a t u r a n P e m e r i n t a h N o m o r 2 7 T a h u n 2 0 1 2 t e n t a n g I z i n

L i n g k u n g a n ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n

2 0 1 2 N o m o r 4 8 ) ;

1 L P e r a t u r a n P e m e r i n t a h N o m o r 9 6 T a h u n 2 0 1 2 t e n l a n g

P e l a k s a n a a n U n d a n g - U n d a n g N o m o r 2 5 T a h u n 2 0 0 9

t e n t a n g P e l a y a n a n P u b l i k { L e m b a r a n N e g a r a R e p u b l i k

I n d o n e s i a T a h u n 2 0 1 2 N o m o r 2 1 5 , T a m b a h a n L e m b a r a n


1 2 . P e r a t u r a n P r e s i d e n N o m o r 9 7 T a h u n 2 0 1 4 t e n t a n g

P e n y e l e n g g a r a a n P e l a y a n a n T e r p a d u S a t u F H n t u

( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 1 4 N o m o r

2 2 1 ) ;

1 3 . P e r a t u r a n P r e s i d e n R e p u b l i k I n d o n e s i a N o m o r 9 1 T a h u n

2 0 1 7 t e n t a n g P e r c e p a t a n P e l a k s a n a a n B e r u s a h a

( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 1 7 N o m o r

1 9 5 6 ) ;

1 4 . P e r a t u r a n M e n t e r i P e n d a y a g u n a a n A p a r a l u r N e g a r a d a n

R e f o r m a s i B i r o k r a s i N o m o r 3 5 T a h u n 2 0 3 4 t e n t a n g

P e d o m a n S t a n d a r P e l a y a n a n ( B e r i t a N e g a r a R e p u b l i k

I n d o n e s i a T a h u n 2 0 1 4 N o m o r 6 1 5 ) ;

1 5 - P e r a t u r a n D a e r a h

- 3 -

1 5 . P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r 5 T a h u n

2 0 0 0 t e n t a n g R e t r i b u s i I z i n U s a h a P e r u s a h a a n

P e n g g i l i n g a n P a d i , B u H e r d a n P e n y o s o h a n B e r a s

( L e m b a r a n D a e r a h K a b u p a t e n B o y o l a l i T a h u n 2 0 0 0 N o m o r

4 , S e r i B N o m o r 4 ) ;

1 6 . P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r 1 7 T a h u n

2 0 0 3 t e n t a n g R e t r i b u s i P e m b e n a n I z i n U s a h a R u m a h

M a k a n d a n W a r u i i g M a k a n ( L e m b a r a n D a e r a h K a b u p a t e n

B o y o l a l i T a h u n 2 0 0 3 N o m o r 1 9 , S e r i C ) ;


2 0 0 3 t e n t a n g R e t r i b u s i T e m p a t W i s a l a d a n O l a h R a g a

( L e m b a r a n D a e r a h K a b u p a t e n B o y o l a i i T a h u n 2 0 0 3 N o m o r

2 4 S e r i C ) ;


2 0 0 9 t e n t a n g P e m b a n g u n a n M e n a r a T e l c k o m u n i k a s i d i

K a b u p a t e n B o y o l a l i ( L e m b a r a n D a e r a h K a b u p a t e n B o y o l a l i

T a h u n 2 0 0 9 N o m o r 4 ] ;


2 0 0 9 t e n t a n g P e n y e l e n g g a r a a n K e s e h a t a n ( L e m b a r a n

D a e r a h K a b u p a t e n B o y o l a l i T a h u n 2 0 0 9 N o m o r 5 ,

T a m b a h a n L e m b a r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r

1 1 0 | ;


2 0 1 1 l e n t a n g R e n c a n a T a t a R u a n g W i l a y a h K a b u p a t e n

B o y o l a l i T a h u n 2 0 1 1 - 2 0 3 1 ( L e m b a r a n D a e r a h K a b u p a t e n

B o y o l a l i T a h u n 2 0 1 1 N o m o r 9 ] ;


2 0 1 1 t e n t a n g R e t r i b u s i P e r i z i n a n T e r i e n l u ( L e m b a r a n

D a e r a h K a b u p a t e n B o y o l a l i T a h u n 2 0 1 1 N o m o r 1 3 ) ;

2 2 - P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r 2 T a h u n

2 0 1 2 t e n t a n g P e l a y a n a n P e r i z i n a n d a n N o n P e r i z i n a n

B i d a n g K e s e h a t a n ( L e m b a r a n D a e r a h K a b u p a t e n B o y o l a l i

T a h u n 2 0 1 2 N o m o r 2 , T a m b a h a n L e m b a r a n D a e r a h

K a b u p a t e n B o y o l a l i N o m o r 1 3 1 ) ;

2 3 , P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r 4 T a h u n

2 0 1 2 t e n t a n g P e l a y a n a n P e r i z i n a n d a n N o n P e r i z i n a n

T e r p a d u d i K a b u p a t e n B o y o l a l i ( L e m b a r a n D a e r a h

K a b u p a t e n B o y o l a l i T a h u n 2 0 1 2 N o m o r 4 , T a m b a h a n

L e m b a r a n D a e r a h K a b u p a t e n B o y o l a l i T a h u n 2 0 1 2 N o m o r

1 3 3 ) ;

2 4 - P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r 1 0 T a h u n

2 0 1 2 t e n t a n g B a n g u n a n G e d u n g ( L e m b a r a n D a e r a h

K a b u p a t e n B o y o l a l i T a h u n 2 0 1 3 N o m o r 1 0 , T a m b a h a n

L e m b a r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r 1 3 8 ) ;


2 0 1 3 t e n t a n g I z i n M e n d i r i k a n B a n g u n a n ( L e m b a r a n

D a e r a h K a b u p a t e n B o y o l a l i T a h u n 2 0 1 3 N o m o r 6 ,

T a m b a h a n L e m b a r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r

1 4 4 ) ;


2 0 1 4 t e n t a n g I r i g a s i ( L e m b a r a n D a e r a h K a b u p a t e n

B o y o l a l i T a h u n 2 0 1 4 N o m o r 4 , T a m b a h a n L e m b a r a n

D a e r a h K a b u p a t e n B o y o l a l i N o m o r 1 5 4 ) ;


2 0 1 5 t e n t a n g I z i n U s a h a J a s a K o n s t r u k s i ( L e m b a r a n

D a e r a h K a b u p a t e n B o y o l a l i T a h u n 2 0 1 5 N o m o r 9 ) ;

2 7 . P e r a t u r a n D a e r a h

4


2 0 1 6 l e n t a n g P e m b e n t u k a n d a n S u s u n a n P e r a n g k a t

D a e r a h ( L e m b a r a n D a e r a h K a b u p a t e n B o y o l a l i T a h u n

2 0 1 6 N o m o r 1 6 , T a m b a h a n L e m b a r a n D a e r a h K a b u p a t e n

B o y o l a l i N o m o r 1 8 3 | ;

2 9 . P e r a t u r a n M e n t e r i D a l a m N e g c r i N o m o r 1 3 8 T a h u n 2 0 1 7

t e n t a n g P e n y e l e n g g a r a a n P e l a y a n a n T e r p a d u S a t u P i n t u

D a e r a h ( B e r i t a N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 1 7

N o m o r 1 9 5 6 ;

3 0 . P e r a i u r a n B u p a t i B o y o l a l i N o m o r 3 7 T a h u n 2 0 1 6 t e n t a n g

K e d u d u k a n , S u s u n a n O r g a n i s a s i , T u g a s d a n F u n g s i s e r t a

T a t a K e r j a P e r a n g k a t D a e r a h K a b u p a t e n B o y o l a l i ( B e r i t a

D a e r a h K a b u p a t e n B o y o l a l i T a h u n 2 0 1 6 N o m o r 3 7 ) ;

3 1 . P e r a t u r a n B u p a t i B o y o l a l i N o m o r 6 8 T a h u n 2 0 1 6 t e n t a n g

U r a i a n T u g a s J a b a l a n E s c l o n p a d a D i n a a P e n a n a m a n

M o d a l d a n P e l a y a n a n T e r p a d u S a t u P i n t u K a b u p a t e n

B o y o l a l i ( B e r i t a D a e r a h K a b u p a t e n B o y o l a l i T a h u n 2 0 1 6

N o m o r 6 8 ) ;

M E M U T U S K A N :

M e n e i a p k a n :

K E S A T U : S t a n d a r P e l a y a n a n P e r i z i n a n d a n N o n P e r i z i n a n p a d a D i n a s

p e n a n a m a n M o d a l d a n P e l a y a n a n T e r p a d u S a t u P i n t u

s e b a g a i m a n a t e r s e b u t d u l a m L u m p i r a n y a n g m e r u p a k a n

b a g i a n l a k t c r p i s a h k a n d a r i K e p u t u s a n i n i ,

K E D U A : S t a n d a r P c l a y a n a n P e r i z i n a n s e b a g a i m a n a d i r n a k s u d d a l a m

d i k l u m K E S A T U m e l i p u l i j e n i s p c l a y a n a n p e r i z i n a n d a n n o n

p e r i z i n a n s e b a g a i b e r i k u l :

1 . I z i n P e r u n t u k a n P e n g g u n a a n T a n a h ( I P P T ) ;

2 . I z i n U s a h a P e r d a g a n g a n ;

3 . T u n d a D a f t a r P e r u s a h a a n ( T D P ) ;

4 . S u r a l I z i n U s a h a T n d u s i r i ( S I U l | ( m o d a l 5 0 0 j u t a s / d 1 0

M , N o n I n d u s t r i , P e n g g u b u n g a n d a n P c r l u a s a n ) ;

5 . P e n d a f t a r a n P e n a n a m a n M o d a l { s e k l o r N o n I n d u s i r i ) ;

6 . i z i n L o k a s i ;

7 . T a n d a D a f t a r G u d a n g ( T D G ) ;

8 . I z i n U s a h a B u r u n g W a l e t / S n t i ;

9 . R i c e M i l l U n i t ( R M U ) ;

1 0 . P e n d a f t a r a n P e n a n a m a n M o d a l ( s e k t o r i n d u s t r i ) m o d a l

d i b a w a h 1 0 M ;

1 1 . P e n d a f t a r a n P e n a n a m a n M o d u i P e r u b a h a n ;

1 2 . P e n d a f t a r a n P e n a n a m a n M o d a l P c r l u a s a n ;

1 3 . i z i n i c r h a d a p I n s i a l a i u r K a b c l R u m a h / G e d u n g ( I K R / G ) ;

1 4 . I z i n k a n i o r c a b a n g l o k e t p e l a y a n a n o p e r a t o r ;

1 5 . I z i n g a l i a n u n t u k k e p e r l u a n p e n g g e l a r a n k a b c l

l e i e k o m u n i k a s i d a l a m s a t u K a b u p a t e n ;

1 6 . I z i n U s a h a W a r u n g I n t e r n e t d a n G a m e - N e t ;

1 7 . R u m a h S a k i c U m u m T y p e C . D ;

1 8 . R u m a h S a k i t K h u s u s T y p e C ;

1 9 . K l i n i k P r a t a m a ;

2 0 . K l i n i k U t a m a ;

2 1 . T a n d a D a f t a r I n d u s t r i ;

2 2 . S u r a t I z i n

- 5 -

2 2 . S u r a t i z i n U s a h a P e t e m a k a n ;

2 3 . I z i n P c r l u a s a n U s a h a I * e t e m a k a n ;

2 4 . T a n d a D a f t a r P e t e m a k a n R a k y a t ;

2 5 . T D U P P e n y e l e n g g a r a a n K e g i a t a n H i b u r a n d a n R p k r e a s i :

2 6 . T D U P P e n g e l o l a a n D a y a T a n k W i s a t a ;

2 7 . T D U P P e n y e d i a a n A k o m o d a s i ,

2 8 . T D U P J a s a T r a n s p o r l a s i W i s a t a ;

2 9 . T D U P J a s a m a k a n a n d a n m i n u m a n ;

3 0 . T D U P J a s a P e r j a l a n a n W i s a C a ;

3 1 . T D U P K o n s u l i a s i P a n w i a a t a ;

3 2 . T D U P I n f o r m a s i P a r i w i s a t a ;

3 3 . T D U P J a s a P r a m u w i s a t a ;

3 4 . T D U P W i s a t a T u l a ;

3 5 . T D U P S p a ;

3 6 . T D U P K a w a s a n W i s a t a ;

3 7 . T D U P P e n y e l e n g g a r a a n P e r t e m u a n d a n P a m e r a n :

3 8 . I z i n M e n d i r i k a n B a n g u n a n [ 1 M B ) ( s e d e r h a n a d a n

k o m p l e k s i T a s | ;

K E T I G A ; S t a n d a r P e l a v a n a n s e b a g a i m a n a d i m a k s u d d a l a m d i k l u m

K E S A T U d i g u n a k a n s e b a g a i a c u a n d a l a m p e m b e n a n

p e l a y a n a n p e r i z i n a n d a n n o n p e r i z i n a n d a l a m r a n g k a

m e n i n g k a t k a n k i n e r j a d a n k u a l i t a s p e l a y a n a n s e r t a

p e m b e n a n k e p a a i i a n k e p a d a p e m o h o n l > a i k m e n g e n a i

k e p a s t i a n b i a v a m a u p u n j a n g k a w a k t u l a m a n y a p r o s e s

l a v a n a n p e n c r b i t a n / p e n c l a p a n p e r z i n a n d a n n o n p e n z i n a n .

K E E M P A T : J a n g k a w a k t u p e n e r b i l a n / p e n e t a p a n p e n z i n a n s e b a g a i m a n a

d i m a k s u d d a l a m d i k t u m K E T I G A d i l a k u k a n d e n g a n

m e m p e r h i l u n g k a n -

a . J a n g k a w a k t u l a m a n y a p e m b e r i a n R e k o m e n d a s i d a r i T i m

T e k n i s m a u p u n R e k o m e n d a s i d a r i D i n a s T e k n i s y a n g

m e m b i d a n g i s e s u a i d e n g a n k e l e n i u a n P e r a i u r a n B u p a u

B o y o l a l i N o m o r 1 0 T a h u n 2 0 1 3 T e n t a n g P e t u n j u k

P e l a k s a n a a n P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i N o m o r

4 T a h u n 2 0 1 2 t e n t a n g P e l a y a n a n P e n z m a n d a n N o n

P e r i z i n a n T e r p a d u K a b u p a t e n B o y o l a l i s e t e l a h d i a d a k a n

p e m e n k s a a n t e k n i s d i l a p a n g a n o l e h T i m T e k n i s :

b - K o m p l e k s i t a s j e m s p e n z m a n y a n g m e m e r l u k a n k a j i a n

t e k n i s b a i k d a r i T i m T e k n i s m a u p u n D i n a s T e k n i s > a n g

m e m b i d a n g i s e s u a i d e n g a n t u g a s d a n k e w e n a n g a n

m a s i n g - m a s i n g :

c , J a n g k a w a k t u d a r i l i n d a k l a n j u l a l a s p e n y e l e s a i a n

t e m u a n p e r m a s a l a h a n p e n z i n a n b a i k m e n g e n a i

p e r s y a r a t a n t e k n i s , a d m m i s t r a s i m a u p u n k e b e r a t a n d a n

m a s v a r a k a l y a n g b a r u s d i t i n d a k l a n j u i i o l e h p e m o h o n

d a n / a i a u D i n a a T e k n i s v a n g m e m b i d a n g i ,

d - L a m a n y a p r o s e s p e n e r b i t a n / p e n e t a p a n d i h i t u n g s e t e l a h

b e r k a s d i n y a t a k a n l e n g k a p d a n b e n a r s e s u a i d e n g a n

p e r s y a r a t a n y a n g t e l a h d i t e n t u k a n ;

K E L I M A

- 6 -

: S e t e l a h p e n z m a n d a n n o n p e r i z i n a n d i t e l a p k a n w a j i b s c g e r a

d i b e r i t a h u k a n k e p a d a p e m o h o n m e l a l u i S M S G e t w a y .

: T a n g g a l p e m b e n t a h u a n m e l a l u i S M S G e t w a y s e b e g a i m a n a

d i m a k s u d d a l a m d i k t u m K E L I M A m e r u p a k a n a k h i r j a n g k a

w a k t u p r o s e s p e n y e l e s a i a n p e r i z i n a n d a n n o n p e r i z i n a n .

: P e n y e l e n g g a r a a n P e r i z i n a n d a n N o n P e r i z i n a n p a d a D i n a s

P e n a n a m a n M o d a l d a n P e l a y a n a n t e r p a d u S a t u P i n t u

d i l a k s a n a k a n d e n g a n m e n e r a p k a n T e k n o l o g i I n f o r m a s i

O n l i n e m e l a l u i A p l i k a a i S i s t e m I n f o r m a s i P e l a y a n a n

P e r i z i n a n ( S I P P ) b e r b a s i s T r a c k i n g S y s t e m .

: D e n g a n b e r l a k u n y a K e p u t u s a n i n i , m a k a K e p u t u s a n K e p a l a

D i n a s P e n a n a r n a n M o d a l d a n P e l a y a n a n T e r p a d u S a t u P i n t u

K a b u p a t e n B o y o l a l i N o m o r 5 0 3 / 4 4 1 1 T a h u n 2 0 1 7 t e n l a n g

P e n e t a p a n S t a n d a r P e l a y a n a n P e r i z i n a n d a n N o n P e r i z i n a n

p a d a D i n a s P e n a n a m a n M o d a l d a n P e l a y a n a n T e r p a d u S a t u

P i n t u d i c a b u t d a n d i n y a t a k a n t i d a k b e r l a k u l a g i .

: K e p u t u s a n i n i m u l a i b e r l a k u p a d a t a n g g a l d i t e t a p k a n .

D i t e t a p k a n d i B o y o l a l i

p a d a t a n g g a l 1 / p a r W O A 2 0 1 8

K E P A L A D I N A S P E N A N A M A N M O D A L D A N

S a l i n a n K E P U T U S A N i n i d i s a m p a i k a n k e p a d a Y t h . :

1 . B u p a t i B o y o l a l i ;

2 . E n a p e k t u r I n s p e k t o r a t K a b . B o y o l a l i ;

3 . K a b a g . O r g a n i s a a i S e t d a K a b , B o y o l a l i ;

4 . K a b a g . H u k u m S e t d a . K a b , B o y o l a l i

6 . P e r t m g g a l .

K E L I M A

K E E N A M

K E T U J U H

K E D E L A P A N

K E S E M B I L A N

L A M P I R A N

K e p u t u s a n K e p a J a D i n a s P e n a n a m a n

M o d a l d a n P c l a y a n a n T e r p a d u S a t u P i n t u

N o m o r 5 0 3 / 1 C 7zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA T ahun 2 0 1 8

T a n g g a l 17 ^ d U O " " ! 2 0 1 8

A. PENDAHULUAN

M c m u a i g a m b a r a n u m u m s e c a r a s i n g k a l t e n t a n g t u g a s d a n f u n g s i s e r t a

k e b c r a d a a n u n i t p e n y e l e n g g a r a p e l a y a n a n s e s u a i d e n g a n p e r a t u r a n

p e r u n d a n g a n y a n g b e r l a k u .

B. ST A NDA R PELAY ANAN

1. J e n i s P e l y anan I z i n P e runt uk an Penggunaan T an ah (IPPT )

NO K O M P O N E N URAIAN

1 , Dasar H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i

N o m o r 1 3 T a h u n 2 0 1 1 t e n t a n g

R e t r i b u s i P e r i z i n a n T e r t e n t u .

• P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i

N o m o r 4 T a h u n 2 0 1 2 t e n l a n g

P c l a y a n a n P e n z m a n d a n N o n

P e r i z i n a n T e r p a d u K a b u p a t e n

B o y o l a l i ,

• P e r a t u r a n B u p a l i B o y o l a l i N o m o r 1 0

T a h u n 2 0 1 3 t e n l a n g P e t u n j u k

P e l a k s a n a a n P e r a t u r a n D a e r a h

K a b u p a t e n B o y o l a l i N o m o r 4 T a h u n

2 0 1 2 t e n t a n g P c l a y a n a n P e r i z i n a n

d a n n o n P e r i z i n a n T e r p a d u

K a b u p a t e n B o y o l a l i

2 . P e r s a y a r a t a n P c l a y a n a n a. Mengisi Blanko Permohonan;

b . F o t o c o p y K T P P e m o h o n y a n g m a s i h

b e r l a k u ( j i k a s u a m i / i s t r i W N A )

m e l a m p i r k a n F o t o c o p y P a s p o r ;

c. F o t o c o p y N P W P ;

d . M a l c r a i R p . 6 0 0 0 , - ;

e. F o t o c o p y S e r t i f i k a l / B u k t i

k e p e m i l i k a n t a n a h ;

f. F o t o c o p y s a h A k t e

P e n d i n a n / P e r u b a h a n n y a y a n g m a s i h

b e r l a k u b a g i p e m o h o n y a n g b e r b a d a n

h u k u m ;

g . S u r a l K u a s a ( a p a b i l a d i k u a s a k a n ) ;

h . F o t o c o p y I z i n U s a h a ;

i . S k e t L c t a k L o k a s i y a n g d i m o h o n ;

j . P e r s e t u j u a n p r i n a i p d a r i i n s l a n s i

y a n g b e r w e n a n g ( a p a b i l a t a n a h n y a

m e r u p a k a n a s e l n e g a r a ) ;

k - D o k u m c n p e n u n j a n g l a i n n y a

( d o k u m e n p e n u n j a n g y a n g b e r k a i i a n

d e n g a n l a n a h y a n g d i m o h o n ) ;

1. R e k o m e n d a s i d a r i I n s t a n s i T e k n i s

t e r k a i i .

3 . S i s t e m , m e k a n i s m e ,

d a n p r o s e d u r

L P e m o h o n m e n g a m b i l b l a n g k o s e s u a i

k e b u i u h a n y a n g j u g a t e l a h

d i s e d i a k a n p a d a r u a n g i n f o r m a s i ,

2 . S e t e l a h b l a n g k o d i i s i d a n p e m y a t a a n

l e n g k a p o l e h p e m o h o n d i k c m b a l i k a n

u n t u k d i d a f t a r , s e l a n j u t n y a d i b e r i

t a n d a b u k l i p e n d a f t a r a n .

3 . P r o s e s :

• f i e m b a h a s a n / k a j i a n d a l a m

m e n i n d a k l a n j u t i p e r m o h o n a n

t e r s e b u t .

• M e l a k u k a n p e m e r i k s a a n l o k a s i .

4 . S c l e s a i p r o s e s i j i n d a p a l d i a m b i l p a d a

i o k c t p e n g a m b i l a n .

4 . J a n g k a w a k t u

p e n y e l e s a i a n

7 ( t u j u h ) b a n k e i j a d a r i b e r k a s

p e r m o h o n a n d i t e r i m a l e n g k a p d a n

b e n a r o l e h v e r i f i k a l o r .

5 . B i a v a / t a r i f f R p . 0 , -

6 . P r o d u k D c l a v a n a n S K

7 . S a r a n a , p r a s a r a n a

d a n / a i a u f a s i l i t a s

M e j a , k u r s i , c o m p u t e r , P r i n t e r ,

I n l e m e l / A p l i k a s i s i s t e m / W e b / E m a i l ,

s m s s e r v i c e , g p s , A T K d a n m o b i l .

8 . K o m p e l e n s i p e i a k s a n a D i k l a i P T S P . S M A / D 3 . S l -

9 . P e n g a w a s a n i n t e r n a l R a p a t s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i

a p l i k a a i s i s t e m .

1 0 , P e n a n g a n a n

p e n g a d u a n , s a r a n , d a n

m a s u k a n

• P e n g a d u a n d a t a n g k e D P M P T S P d i

p e r s i l a h k a n m a s u k k e r u a n g K h u s u s

p e n g a d u a n d a n d i f a s i l i t a s i d e n g a n

s o l u s i o l e h p e t u g a s p e n e r i m a

p e n g a d u a n .

> P e n g a d u a n d a p a t m e l a l u i k o t a k

s a r a n , w e b , d a n s m s d e n g a n f o r m a t

l e r l e n l u k c n o m o r p e n g a d u a n

D P M P T S P d a n a k a n d i b a l a s d e n g a n

s o l u s i a d u a n .

1 1 - J u m l a h p e i a k s a n a 4 o r a n g .

1 2 . J a m i n a n p e l a y a n a n S O P . G r a t i s

1 3 , J a m t n a n k e a m a n a n

d a n k e s e l a m a t a n

p e l a v a n a n

N o m o r a n t r i a n d a n r u a n g t u n g g u b e r

a c . t v . M e j a h e l p d e s k , C C T V

1 4 . E v a l u a s i k i n e r j a

p e i a k s a n a

I K M t i a p 6 b u l a n . zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

2. J e n i s P e Uy an x n I z l n U u h a Pe rdagangan.

NO K OMPONEN URAIAN

1 - D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i


R e t r i b u s i P e r i z i n a n T c r t r n l u .

• P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a i i


P e l a y a n a n P e r i z i n a n d a n N o n


B o v o l a l i .

-2 -

NO K OMPONEN zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAU R A I A N

• P e r a i u r a n B u p a t i B o y o l a l i N o m o r 1 0

T a h u n 2 0 1 3 t e n t a n g P e t u n j u k



2 0 1 2 t e n t a n g P e l a y a n a n P e n z i n a n


K a b u p a t e n B o v o l a l i

2 . P e r s a y a r a t a n Pe lay anan a . M e n g i s i B l a n k o P e r m o h o n a n ;


b e r l a k uzywvutsrponmlkjihgfedcbaTSRPKJGA i)ika s u a m i / i s t r i W N A )


c. P a s f o t o b e r w a m a s e t e n g a h b a d a n

u k u r a n 4 X 6 ( 2 I b r ) ;

d . S u r a t [ z i n d a r i p i m p i n a n b a g i T N I ,

P O L R i a t a u P N S ;

e . F o t o c o p y N P W P ;

f. M a i e r a i R p , 6 0 0 0 , - :

g . F o t o c o p y s a h A k t e

P e n d i n a n / P e r u b a h a n n y a y a n g

m a s i h b e r l a k u b a g i p e m o h o n y a n g

b e r b a d a n h u k u m ;

h . S u r a t K u a s a ( a p a b i l a d i k u a s a k a n )

i . N e r a c a p e r u s a h a a n , s u s u n a n

p e n g u r u s d a n p e m e g a n g s a h a m ;

j . M e l a m p i r k a n S l U P A s l i b a g i y a n g

m e l a k u k a n d a f t a r u l a n g , p e r u b a h a n

a t a u p e n g g a n t i a n .

3 . S i s t e m , m e k a n i s m e ,

d a n p r o s e d u r

1 . P e m o h o n d a p a t m e n g a m b i l /

m e n d o w l o a d b l a n g k o s e s u a i

k e b u t u h a n y a n g j u g a t e l a h

d i s e d i a k a n p a d a r u a n g i n f o r m a s i

m a u p u n W e b r e s m i D P M P T S P .


l e n g k a p o l e h p e m o h o n d a p a t

d i k c m b a l i k a n u n t u k d i d a f t a r

l a n g s u n g m a u p u n m e l a l u i o n l i n e d a n

p a t e n , s e l a n j u m y a d i b e r i t a n d a b u k t i

p e n d a f t a r a n .

3 . P r o s e s p e m b a h a s a n / k a j i a n d a l a m


t e r s e b u t .

4 . S e l e s a i p r o s e s i j i n d a p a t d i a m b i l

p a d a l o k e t p e n g a m b i l a n .

4 , J a n g k a w a k t u


5 { l i m a ) h a r i k e r j a d a r i b e r k a s


b e n a r o l e h v e r i f i k a t o r .

5 , B i a y a / t a r i l T R p . 0 , .

6 . P r o d u k p e l a v a n a n S K


d a n / a t a u f a s i l i t a s

M e j a , k u r s i , c o m p u t e r . P r i n t e r ,

I n t e r n e t / A p l i k a s i s i s t e m / W e b / E m a i l ,


8 . K o m p e t e n s i p e i a k s a n a D i k l a t F T S P , S M A / D 3 , S I .


a p l i k a s i s i s t e m .



m a s u k a n



P e n g a d u a n d a n d i f a s i l i t a s i d e n g a n


p e n g a d u a n .

• P e n g a d u a n d a p a t m e l a l u i k o t a k


t e r t e n l u k e n o m o r p e n g a d u a n



1 1 . J u m l a h p e i a k s a n a 6 o r a n g -

1 2 . J a m i n a n p e l a v a n a n S O P , G r a t i a

1 3 , J a m i n a n k e a m a n a n

d a n k e s e l a m a t a n

p e l a v a n a n

N o m o r a r i t r i a n d a n r u a n g t u n g g u b e r

a c . t v , M e j a h e l p d e s k , C C T V

1 4 . E v a J u a s i k i n e r j a

p e i a k s a n a

I K M t i a p 6 b u l a n .

3 . J e n i a P c l a y a n a n T a n d a D a f t a r P e n i a a h a a n ( T O P ) .

N O K O M P O N E N U R A I A N

1 . D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n

B o y o l a l i N o m o r 1 3 T a h u n 2 0 1 1

t e n t a n g R e t r i b u s i P e r i z i n a n T e r t e n t u .

• P e r a t u r a n D a e r a h K a b u p a t e n

B o y o l a l i N o m o r 4 T a h u n 2 0 1 2

t e n t a n g P e l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,

• P e r a t u r a n B u p a t i B o y o l a l i N o m o r 1 0




2 0 1 2 t e n t a n g P e l a y a n a n P e r i z i n a n


K a b u p a t e n B o y o l a U

2 . P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n k o P e r m o h o n a n ;



m e l a m p i r k a n F o i o c o p y P a s p o r ;

c- F o t o c o p y s a h A k t e

P e n d i r i a n / P c r u b a h a n n y a y a n g m a s i h

b e r l a k u b a g i p e m o h o n y a n g


d . S u r a t I z i n d a r i p i m p i n a n b a g i T N I ,

P O L R ] a t a u P N S ;

e . N e r a c a p e r u s a h a a n , s u s u n a n


f. F o t o c o p y I z i n U s a h a / S u r a t

K e t e r a n g a n y a n g d i p e r s a m a k a n

d i t e r b i l k a n o l e h i n s l a n s i t e k n i s ;

g . M e l a m p i r k a n T D P a s l i b a g i p e m o h o n

y a n g m e l a k u k a n d a f t a r u J a n g ,

p e r u b a h a n a t a u p e n ^ a n t i a n .


3 . S i s t e m , m e k a n i s m e , d a n

p r o s e d u r

1 - P e m o h o n d a p a t m e n g a m b i l /




m a u p u n W e b r e s m i D P M P T S P , ywtronmjfZWVMKJFA

2. S e l e i a h b l a n g k o d i i s i d a n p e m y a t a a n

l e n g k a p o J e h p e m o h o n d a p a t



p a t e n , s e i a n j u t n y a d i b e r i t a n d a b u k t i




t e r s e b u t .



J a n g k a w a k t u


5 ( l i m a ) h a r i k e r j a d a r i b e r k a s


b e n a r o l e h v e r i f i k a l o r .

5 . B i a y a / t a r i f f R p . 0 , -

6 . P r o d u k p e l a y a n a n zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBAS K



M e j a , k u r s i . c o m p u t e r . P r i n t e r ,


s m s s e r v i c e , g p s , A T K d a n m o b i h

8 . K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 , S I ,

9 . P e n g a w a s a n i n t e r n a l R a p a t s t a f s e t i a p bulan, laporan melalui


1 0 . E ^ n a n g a n a n


m a s u k a n





p e n g a d u a n ,

• P e n g a d u a n d a p a l m e l a l u i k o t a k

s a r a n , w e b , d a n s m s d e n g a n f o r m a l

t e r t e n t u k e n o m o r p e n g a d u a n



1 1 , J u m l a h p e i a k s a n a 6 o r a n g .

1 2 , J a m i n a n p c l a y a n a n S O P , G r a t i s

1 3 . J a m i n a n k e a m a n a n d a n

k e s e l a m a t a n p e l a v a n a n


a c l v , M e j a h e l p d e s k . C C T V

1 4 . E v a l u a s i k i n e i j a

p e i a k s a n a

IKM t i a p 6 b u i a n .

4 . J e n i s P e l sy anan Surat I z i n Usaha I ndust r i (SIUI ).


I . D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n


t e n t a n g R e t r i b u s i P e r i z i n a n T e r t e n t u ,




- 5 -

NO zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAK O M P O N E N U R A I A N


B o y o l a U .





2 0 1 2 t e n l a n g P e l a y a n a n P e r i z i n a n



2 , P e r s a y a r a t a n P c l a y a n a n a . M e n g i s i B l a n k o P e r m o h o n a n ;

b . F o i o c o p y K T P P e m o h o n y a n g m a s i h



c . P a s f o t o b e r w a r n a s c t e n g a h b a d a n

u k u r a n 4 X 6 ( 2 i e m b a r ) ;

d . F o t o c o p y N P W P ;

e. F o t o c o p y s a h A k t e




f. F o t o c o p y 1 M B ;

g . N e r a c a p e r u s a h a a n ( m o d a l d i a t a s R p .

5 0 J u t a } , s u s u n a n p e n g u r u s d a n

p e m e g a n g s a h a m ;

h . F o t o c o p y

A M D A L / U K L / U P L / D P P L / S P P L / A N D

A L A L I N .

3 . S i s t e m , m e k a n i s m C t d a n

p r o s e d u r





m a u p u n W e b r e s m i D P M P T S P ,





p a t e n , s e l a n j u m y a d i b e r i r a n d a b u k t i




t e r s e b u t .





3 ( t i g a } h a r i k e r j a d a r i b e r k a s


b e n a r o l e h v c r i r i k a t o r .

5 . B i a y a / t a r i f f R p ^ 0 , -

6 . P r o d u k p e l a y a n a n SK



M e j a , k u r s i . c o m p u t e r , P r i n t e r ,



8 . K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 , S L

- 6 -






m a s u k a n





p e n g a d u a n .

• P e n g a d u a n d a p a t m e l a l u i k o i a k

s a r a n , w e b . d a n s m s d e n g a n f o r m a t


D P M P I S P d a n a k a n d i b a l a s d e n g a n


I I , J u m l a h p e i a k s a n a 6 o r a n g .

1 2 , J a m i n a n p e i a v E u i a n S O P . G r a t i s


k e s e l a m a t a n p e l a y a n a n

N o m o r a n t r i a n d a n r u a n g t u n g g uzyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA ber

a c . t v . M e j a h e l p d e s k . CCT V

14- E v a l u a s i k i n e r j a

p e i a k s a n a


5 , Pe ndaf t aran P e nanam an Modal




t e n l a n g R e t r i b u s i P e r i z i n a n T e r t e n t u .

• P e r a i u r a n D a e r a h K a b u p a t e n



B o y o l a l i ,





2 0 1 2 l e n t a n g P e l a y a n a n P e r i z i n a n





b e r l a k u ( j i k a s u a m i / i s t r i W N A |


c . F o t o c o p y N P W P ;

d . F o t o c o p y S e r t i f i k a l / B u k t i


e . S u r a t K e s e s u a i a n d e n g a n T a t a R u a n g

( R T R W ) ;

f. S u r a t P e m y a t a a n P e r s e t u j u a n

L i n g k u n g a n / t e t a n g g a y a n g

b c r b a t a a a n l a n g s u n g d i k e t a h u i o l e h

K e p a l a D e s a / L u r a h d a n C a r n a l ;

g - S u r a t P e m y a t a a n K e s a n g g u p a n

P e n g e l o l a a n L i n g k u n g a n ( R P P L ) /

A M D A L / U K L - U P L / A N D A L A L I N ;

-7 -


h . P r o p o s a l ( U r a i a n t e n t a n g K e g i a t a n

U s a h a y a n g a k a n d i j a l a n k a n d a n

j u m l a h t e n a g a k e r j a ) ;

i . G a m b a r S i t u a s i / D e n a h L o k a s i

U s a h a .

3 . S i s t e m , m e k a n i s m e . d a n

p r o s e d u r

1 . p e m o h o n m e n g a m b i l b l a n g k o s e s u a i

k e b u t u h a n y a n g j u g a l e J a h d i s e d i a k a n

p a d a r u a n g i n f o r m a s i ,

2 . S e t e l a h b l a n g k o d i i a i d a n p e m y a t a a n

l e n g k a p o l e h p e m o h o n d i k e m b a l i k a n

u n t u k d i d a f t a r , s e i a n j u t n y a d i b e r i

t a n d a b u k l i p e n d a f t a r a n .

3 . P r o s e s :

• p e m b a h a s a n / k a j i a n d a l a m


t e r s e b u t .


4 . S e l e s a i p r o s e s i j i n d a p a t d i a m b i l p a d a

l o k e t p e n g a m b i l a n .



7 ( t u j u h ) h a r i k e r j a d a r i b e r k a s


b e n a r o l e h v e n f i k a l o r .

5 . B i a y a / t a r i f f R p . 0 . -







8 , K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 . S L



1 0 . P e n a n g a n a n

p e n g a d u a n . s a r a n . d a n

m a s u k a n




s o l u s i o l e h p e t u g a s p e n e n m a

p e n g a d u a n .


s a r a n . w e b . d a n s m s d e n g a n f o r m a t




1 1 . J u m l a h p e i a k s a n a 4 o r a n g -

1 2 . J a m i n a n p e l a y a n a n S O P , G r a t i s

1 3 , J a m i n a n k e a m a n a n d a n


N o m o r a n t r i a n d a n r u a n g l u n g g u b e r

a c . t v , M e m h e l p d e s k , C C T V

1 4 , E v a l u a s i k i n e r j a

p e i a k s a n a


6 . J e n i s P e Uy an sn I z l n L o k asi .

N O K O M P O N E N URAIAN







t e n t a n g P c l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,










b e r l a k u { j i k a s u a m i / i s t r i W N A )


c . F o i o c o p y N P W P ;

d . F o i o c o p y S e r t i f i k a t / B u k l i


e . F o i o c o p y s a h A k t e




f. I z i n P r i n s i p ;

g . A s p e k P e n a i a g u n a a n T a n a h / A n a l i s i s zywvutsrponmlkjihgfedcbaTSRPKJGA

Geographic information System ( G I S ) ;

h . S u r a t K u a s a ( a p a b i l a d i k u a s a k a n ) ;

i . P r o p o s a l P e n g a j u a n I z i n L o k a s i ;

j . G a m b a r k a s a l / S k e t s a T a n a h y a n g

d i m o h o n d a n Sue Plan;

k . F o t o c o p y S u r a t P e r s e t u j u a n

P e n a n a m a n M o d a l d a n I n s t a n s i y a n g

b c r w e n a n g ( b a g i p e r u s a h a a n y a n g

m e n g g u n a k a n f a s i l i t a s p e n a n a m a n

m o d a l ) ;

I . P e r s e t u j u a n p r i n s i p d a r i I n s l a n s i

y a n g b e r w e n a n g ( a p a b i l a l a n a h n y a

m e r u p a k a n a s e t n e g a r a ) ;

m . P e m y a t a a n l u a s t a n a h y a n g l e l a h

d i m i l i k i p e m o h o n d a n p e r u s a h a a n

p e r u s a h a a n l a i n y a n g m e r u p a k a n

s a t u g r u p d e n g a n n y a ;

n . R e k o m e n d a s i T e k n i s d a r i I n s t a n s i

T e k n i s t e r k a i t .

3 . S i s t e m . m e k a n i s m e . d a n

prosedur

1 . P e m o h o n d a p a t m e n g a m b i l

/ m e n d o w l o a d b l a n g k o s e s u a i


d i s e d i a k ^ i n p a d a r u a n g i n f o r m a s i

m a u p u n W e b r e s m i D P M P I S P . ywtronmjfZWVMKJFA

2. S e t e l a h b l a n g k o d i i s i d a n p e m y a t a a n


d i k e m b a l i k a n u n t u k d i d a f t a r

l a n g s u n g m a u p u n m e l a l u i o n l i n e ,

s e l a n i u t n y a d i b e r i t a n d a b u k t i

-9-

N O K O M P O N E N zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBAURAIAN

p e n d a f t a r a n ,

3 . P r o s e s :

• P e m b a h a s a n / k a j i a n d a l a m


t e r s e b u t .


4 . S e l e s a i p r o s e s i j i n d a p a C d i a m b i l

p a d a L o k e t p e n g a m b i l a n .



7 ( t u j u h } h a r i k e i j a d a n b e r k a s



5 . B i a y a / l a r i f T R p . 0 , -

6 . P r o d u k p e l a y a n a n S K zywvutsrponmlkjihgfedcbaTSRPKJGA

7. S a r a n a , p r a s a r a n a

d a n / a t a u f a s i L i t a s




8 - K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 , S I ,





m a s u k a n





p e n g a d u a n .






l i . J u m l a h p e i a k s a n a 4 o r a n g .





a c , i v . M e i a h e l p d e s k


p e i a k s a n a


7 . J e n i a Pe l ay anan T anda Daf lar Gudang (TDG).

N O K O M P O N E N URAIAN

L D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n


t entang R e t r i b u s i P e r i z i n a n T e r t e n t u .



t e n l a n g P e l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,







- l<V


K a b u p a t e n B o y o i a L i



b e r l a k u ( j ' h a s u a m i / i s t n W N A )



d . P a s f o l o b e r w a r n a s e t e n g a h b a d a n

u k u r a n 4 X 6 ( 2 l e m b a r ) ;

e . F o t o c o p y s a h A k t e




f. F o i o c o p y 1 M B G u d a n g ;

g . M e l c r a i R p . 6 0 0 O , - ;

h . F o i o c o p y S l U P a t a u i z i n u s a h a d a r i

I n s t a n s i T e k n i s l a i n n y a ;

i . F o t o c o p y P e r i z i n a n P e m a k a i a n

G u d a n g b a g i y a n g

m e n y e w a / m e m a n f a a t k a n g u d a n g

p i h a k l a i n ;

j . F o t o c o p y P e t a / D e n a h G u d a n g ;

k . M e l a m p i r k a n T D G a s l i , b a g i

p e m o h o n y a n g m e l a k u k a n d a f t a r

u l a n g , p e r u b a h a n a l a u p e n ^ a n t i a n .

3 . S i s t e m , m e k a n i s m c , d a n

p r o s e d u r

1 , P e m o h o n d a p a l m e n g a m b i l


k e b u i u h a n y a n g j u g a l e l a h



2 - S e t e l a h b l a n g k o d i i s i d a n p e m y a t a a n




s e i a n j u t n y a d i b e r i t a n d a b u k t i




t e r s e b u t .

4 . S e l e s a i p r o s e s i j i n d a p a l d i a m b i l

p a d a L o k e t p e n g a m b i l a n . .

4 - J a n g k a w a k t u


3 ( t i g a ) h a r i k e r j a d a r i b e r k a s



5 . B i a y a / t a r i f T R p . 0 , -

6 . P r o d u k p e l a y a n a n S K





s m s s e r v i c e , g p s , A T K d a n m o b i l -ywtronmjfZWVMKJFA

& . K o m p e t e n s i p e i a k s a n a D i k l a izyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA FT SP , S M A / D 3 , S I , zywvutsrponmlkjihgfedcbaTSRPKJGA

9. P e n g a w a s a n i n t e r n a l R a p a l s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i


- I I -

1 0 . zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

11.

P e n a n g a n a n


m a s u k a n





p e n g a d u a n .




D P M P T S P d a n a k a n d i b a l a s d e n g a n '


1 0 .

11. J u m l a h p e i a k s a n a 6 orang-

1 2 .

1 3 .

J a m i n a n p r T a v a n a n

J a m i n a n k e a m a n a n d a n


S O P , G r a t i s

N o m o r a n i n a n d a n r u a n g l u n g g u b e r

a c , t v , M c i a h e l p d e s k , C C T V


p e i a k s a n a


S. J e n i s Pe l ay ao ao Tz in U u h a Burung Wmle t/Srl t i .


1. Dasar H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n


l e n t a n g R e t r i b u s i P e r i z i n a n T e r t e n l u .



l e n t a n g P c l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,

* P e r a i u r a n B u p a t i B o y o l a l i N o m o r 1 0






K a b u p a t e n B o y o l a l i i

2. Pe rsay arat an Pe layanan a . M e n g i s i B l a n k o P e r m o h o n a n ;


b e r l a k u Q i k a s u a m i / i s t r i W N A )



d . P a s f o t o I x - T w a m a s e t e n g a h b a d a n

u k u r a n 4 X 6 2 ( d u a ) l e m b a r ;

e . F o t o c o p y s a h A k t e



b e r b a d a n h u k u m ,

r F o t o c o p y 1 M B ;

g . R e k o m e n d a s i T e k n i s d a r i I n s t a n s i

T e k m s t e r k a i i .

3 . S i s t e m , m e k a n i s m e . d a n

p r o s e d u r

1 . P e m o h o n d a p a C m e n g a m b i l

/ m e n d o w l o a d b l a n g k o s e a u a i



-12-


m a u p u n W e b r e s m i D P M P T S R ywtronmjfZWVMKJFA

2. S e t e l a h b l a n g k o d i i s i d u n p e m y a t a a n

l e n g k a p o l e h p e m o h o n d a p a l





3 . P r o s e s :

• P e m b a h a s a n / k a j i a n d a l a m XVUTOLKJIHFDCBT T IzywvutsrponmlkjihgfedcbaTSRPKJGA fyvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA n i n H ' l L f l ' i n t t i l l T U > i - m n k i / ^ n t n

j i i c 1111zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA E L i a K i a i i j u i i p e r T j i u n u n a n

t e r s e b u t .


^ , t Z T C i c a a l p i u ^ C 3 IJJIJ u a p a L ui a i i J UL L

4. J a n g k a w a k t u


7 ( t u j u h ] h a r i k e r j a d a r i b e r k a s


b e n a r o l e h v e r i f i k a t o r

5 •J. R i n v n / t a r i f T U J d y a i uni I I I

" P ^ 1

6. P r o d u k p e l a y a n a n S K

7


Meifl k u r s i e n i T i n l i t e r P r i n t e r

1 n l e m e l / A p l i k a s i s i s t e m / W e b / E m a i l ,

s m b s e r v i c e , g p s . A T K d a n m o b i l .

8 . K o m p e t e n s i p e i a k s a n a D . k l a i P T S P . S M A / D 3 . S L

9. P e n g a w a s a n i n t e r n a l R a p a t s t a f s e t i a p b u l a n . l a p o r a n m e l a l u i




m a s u k a n

• P e n g a d u a n d a t a n g k c D P M P T S P d i




n e n on dimci

~ J V 1 l a a U v I t U 1 U d l J c l l I l l d a J u l A U i d n

^ f l r a n w e b d a n s m s rienPHn f o r m a l

t e r t e n l u k c n o m o r p e n g a d u a n

D P M P T S P d a n a k a n d i b a l a s d e n o a n

s f d u s i a d u a n -

T i i m t n l l r v l n k o A O A U U J I I I U I I f . ^ i < i K a d i i a U U I D I I K '





a c p i v , M e j a h e l p d e s k , C C T V

14- E v a l u a s i k i n e r j a

p e i a k s a n a


9 . J e n i a P c l ay nnan I z i n Uaaha Penggi langan padi , Hul l c r dan

P c ny o ao haa Be raa / R i c e MUl Uni t (RHU).


L D a s a r H u k u m • p [ r . i i u n ^ n D a e r a h K a b u p a t e n B o y o l a U

N o m o r 1 3 T a h i m 3 0 1 1 t e n t a n g

R c l n b u s i P e r i z i n a n T e r t e n t u -


N o m o r 4 T a h u n 2 0 1 2 l e n t a n g

P c l a y a n a n P e r i z i n a n d a n N o n


- I V

NO K OMPONEN URAIAN zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

B o y o l a l i ,





2 0 1 2 t e n t a n g P c l a y a n a n P e r i z i n a n d a n

n o n P e r i z i n a n T e r p a d u K a b u p a t e n

B o y o l a l i

2 . P e r s a y a r a l a n P e l a y a n a n a . M e n g i s i B l a n k o P e r m o h o n a n ;





d - P a s f o i o b e r w a m a s e i e n g a h b a d a n

u k u r a n 4 X 6 2 f d u a ) l e m b a r ;

e . M a t e r a i R p . 6 , 0 0 0 . - ;

f . F o t o c o p y s a h A k t e



h u k u m ;

g . F o t o c o p y 1 M B ;

h - M e l a m p i r k a n L z i n R M U a s h . b a g i


u l a n g , p e r u b a h a n a t a u p e n g g a n t i a n .

3 - S i s t e m . m e k a n i s m e , d a n

p r a s e d u r

I . P e m o h o n d a p a t m e n g a m b i l




m a u p u n W e b r e s m i D P M P J S P .





s e i a n j u t n y a d i b e r i l a n d a b u k t i


3 . P r o s e s ;



t e r s e b u t ,









5 - B i a y a / t a r i f f R p . 0 , -

6 , P r o d u k p e l a v a n a n S K

-14^

h . U M P U H E N U R A I A N


d a n / a t a u f a s i l i l a s

M e j a , k u r a i , c o m p u t e r , P r i n t e r ,


s m s s e r v i c e , gp^• , A T K d u n m o b i l .

S - K o m p e t e n s i p e i a k s a n a yvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA1 D i k l a t P T S i \ S M A / D 3 , S L

9 . P e n g a w a s a n i n t e r n a l R a p a l S l a f s e t i a p b u l a n , l a p o r a n m e l a l u i




m a s u k a n





p e n g a d u a n .



t e r t e n t u k c n o m o r p e n g a d u a n



1 1 , J u m l a h p e i a k s a n a 6 o r a n g .

1 2 . J a m i n a n p e l a y a n a n S O P , G r a t i a



N o m o r a n i n a n d a n r u a n g t u r ^ u b e r


1 4 , E v a l u a s i k i n e i j a

p e i a k s a n a


] 0 . J e n i s P c l s y a n u i I z i n P e ndsf t sran P e no nsm an H o d s l (Ho dal

di bawah LO H|.


1 . D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i

N o m o r 1 3 T u h u n 2 0 1 1 t e n t a n g


• P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a U


P e l a y a n a n P e r i z i n a n d a n N o n P e r i z i n a n

T e r p a d u K a b u p a t e n B o y o l a U ,




K a b u p a t e n B o y o l a U N o m o r 4 T a h u n ^

2 0 1 2 l e n t a n g P c l a y a n a n P e r i z i n a n d a n


B o y o l a U

2 , P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n k o P e r m o h o n a n ;





d . M a t e r a i R p . 6 . 0 0 0 , - ;

e . F o t o c o p y S e r t i f i k a l / B u k t i k e p e m i l i k a n

t a n o h ;

f . N e r a c a p e r u s a h a a n , s u s u n a n

p e n g u r u a d a n p e m e g a n g s a h a m ;

g . F o i o c o p y s a h A k t e

P e n d i r i a n / P e r u b a h a n n y a y a n g m a s i h


h u k u m . zywvutsrponmlkjihgfedcbaTSRPKJGA

AS-

N O K O M P O N E N U R A I A N zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

h. S u r a t K u a s a ( a p a b i l a d i k u a s a k a n ) .

3. S i s t e m , m e k a n i s m e , d a n

p r o s e d u r



k e b u i u h a n y a n g j u g a l e l a h d i s e d i a k a n

p a d a r u a n g i n f o r m a s i m a u p u n W e b

r e s m i D P M P T S P . ywtronmjfZWVMKJFA



d i k e m b a l i k a n u n t u k d i d a f t a r l a n g s u n g

m a u p u n m e l a l u i o n l i n e , s e i a n j u t n y a

d i b e r i t a n d a b u k t i p e n d a f t a r a n .

• J . r r u s c a p e i i j u a J i a s a j j / f c a j j a i i u a i a m


t e r s e b u t .

*t . i>c je? Nai p j u s c b i j i i i u a p a i u i d m u i i p a u a 1 i~izywvutsrponmlkjihgfedcbaTSRPKJGA t r , 111yvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA I ' l l 1 o n l UK CL p e i l g a J I L O l i a i l .


p e n y c L e s a i a n

3 ( t i g a ) hari k e r j a d a r i b e r k a s



5 B i a v a / l a r i f T

6 . P r o d u k p e l a v a n a n SK 7 * 3 XVUTOLKJIHFDCBB I - D F I a n r t ^ v 'a T B n ffl o a i c u i a , j j i d s d i i u i v

d a n / a i a u f a s i l i t a s I n t e r n e t / A p l i k a s i s i s t e m / W e b / E m a i l ,

s m s s e r v i c e , g p s . A T K d a n m o b i l .

8 . K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 . S L

9 . P e n g a w a s a n i n l e r n a l R a p a t s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i




m a s u k a n




s o l u s i o l e h p e t u g a s p e n e r i m a rw*rt n ' i H i i n n p C I I g a U U i l 1L.

* r C r i g a u u u j I U a p a x JTLCIOJ UI K OI UA

s a m n H C I T I •airl*! rt^ nETdrt F i i r m t l t T M 3 I d l 1 , W t U , U C E I J L l i : i l K l L l J 1 71 LJIdL


D P M P T S P d a n a k a n d i b a l a s d c n c a n

s o l u s i a d u a n . I L J u m l a h p e i a k s a n a 2 o r a n g

1 2 , J a m i n a n p c l a v c i n u n SOP, G r a t i s




a c i v , M e i a h e l p d e s k , C C T V


p e i a k s a n a

[ K M t i a p 6 b u l a n .

1 1 . Pendaf t aran P e nanam an Modal Pe rubahan.


L D a s a r H u k u m • P e r a i u r a n D a e r a h K a b u p a t e n

B o y o l a l i N o m o r 1 3 T a h u n 2 0 1 I

t e n t a n g R e t r i b u s i P e r i z i n a n T e r t e n l u .

• P e r a i u r a n Dae rah K a b u p a t e n




P e n z i n a n T e r p a d u K a b u p a t e n

B o y o l a l i ,


J a n u n z u 1 t e n t a n g r c l u n j u k



2 0 1 2 t e n t a n g P c l a y a n a n P e n z i n a n


K abupat en B o y o l a l i

2. P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n k o P e r m o h o n a n ;


b e r l a k u ( j i k a s u a m i / i s l r i W N A )



d . M a t e r a i R p . 6 . 0 0 0 , - ;

e . F o t o c o p y S e r t i f i k a t / B u k t i

k c p c m i l i k a n t a n a h ;

r N e r u c B p e r u s a h a a n , s u s u n a n






h . S u r a t K u a s a ( a p a b i l a d i k u a s a k a n ) ; zywvutsrponmlkjihgfedcbaTSRPKJGA

i. P r o p o s a l k e g i a t a n , b e r u p a u r a i a n

p r o s e s p r o d u k s i y a n g

m e n c a n t u m k a n j e n i s b a n a n l ^ a k u

d a n d i l e n g k a p i d e n g a n d i a g r a m

a\it/ flow chart s e r t a u r a i a n k e g i a t a n

s e k t o r j a s a ;

j . R e k o m e n d a s i d a r i I n s l a n s i T e k n i s

t e r k a i t .


p r o s e d u r



k e b u t u h a n y a n g j u g a t e l a h d i s e d i a k a n

p a d a r u a n g i n f o r m a s i m a u p u n W e b

r e s m i D P M P T S P .



d i k c m b a l i k a n u n t u k d i d a f t a r l a n g s u n g

m a u p u n m e l a l u i o n l i n e , s e i a n j u t n y a

d i b e r i t a n d a b u k t i p e n d a f t a r a n .

o . P r o s e s p e m o a n a s a n / k a j i a n a a i a m


t e r s e b u t .

4 . S e l e s a i p r o s e s i j i n d a p a t d i a m o i l p a c t a 1 j-T. 1 V I T 11 I TywtronmjfZWVMKJFA ^'m^ W'm ri 1 •~k 1 T.

j o K c T p e n g a m o i i a T i .



3 ( t i g a ) h a r i k e r j a d a r i b e r k a s

p e r m o h o n a n d i l c n m a l e n g k a p d a n


5, B i a y a / t a r i f T Rp. 0 ,-

6. P r o d u k p e l a v a n a n S K

-17-

N O K O M P O N F N zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBAU f ^ A I A N

7 , S a r a n a D r a s a r a i i * !


M e j a . k u r s i , c o m p u t e r , P r i n t e r ,

I n t e r n e t / A p l i k a s i s i s l e m / W e b / E m a i l ,

s m s s e r v i c e , ; ^ p s , A T K d ; i n T t i o b i l .

8 K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 , S I .

9- P e n g a w a s a n i n t e m a l R a p a t s t a f s e t i a p b u L a n , l a p o r a n m e l a l u i



p e n g a d u a n . s a r a n , d a n

m a s u k a n


p e r s i l a h k a n m a s u k k c r u a n g K h u s u s



D c n t t a d u a n ,

• P e n f t a d u a n d a o a t m e l a l u i k o t a k





1 L J u m l a h p e i a k s a n a 2 o r a n g .

12- J a m i n a n p e l a y a n a n S O P , G r a t i s

13. J a m i n a n k e a m a n a n d a n



a c . t v , M e j a h e l p d e s k . CCT V


p e i a k s a n a

IK M t i a p 6 b u l a n .

1 2 . J e n i a Pe lay anBn I z l n P e nanam an Modal Pe r luaaan

N O K O M P O N E N U R A I A N -M-lyvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA 1

D i t s i i r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n


l e n t a n g R e t r i b u s i P e r i z i n a n T e r t e n t u .



t e n l a n g P c l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,




K a b u p a t e n B o y o l a U N o m o r 4 T a h u n









d . M a t e r a i R p . 6 . 0 0 0 . - ;

e . F o i o c o p y S e r t i f i k a t / B u k t i


f. F o i o c o p y s a h A k t e




g. S u r a l K u a s a ( a p a b i l a d i k u a s a k a n ) ;

h . F o t o c o p y 1 M B ;

J S -


i . F o i o c o p y P e n d a f t a r a n P e n a n a m a n

M c x i a l / l z i n P n n s i p P e n a n a m a n

M o d a l / I z i n P r i n s i p P c r l u a s a n

P e n a n a m a n M o d a l / S u r a t

P e r s e t u j u a n P e n a n a m a n M f x i a l / I z i n

U s a h a d a n / a t a u S u r a l P e r s e t u j u a n

P c r l u a s a n P e n a n a m a n M o d a l / I z i n

U s a h a P c r l u a s a n ;

j . F o tc K - ' O p y L a p o r a n K e g i a t a n

P e n a n a m a n M o d a l ( L K P M ) s e m e s t e r

t e r a k h i r ;

k . F o i o c o p y


A L A L I N ; XVUTOLKJIHFDCB1 .yvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA L i d L ^ U I A J L e i ( L 3 l l i C J L E d J n 3 ( l c l l l L I U V C I V

y a n g d i t a n d a t a n g a m o l e h T i m

P e i a k s a n a L H P , k h u s u s b a g i

k e g i a t a n u s a h a y a n g m e m e r l u k a n

f a s i l i t a s b e a m a s u k a t a s i m p o r

barong d a n bahan.


p r o s e d u r



k e b u t u h a n y a n g J u g a t e l a h


m a u p u n W e b r c s m i D P M P T S P







3 P r o s e s n e m h a h a s a n / k a i i a n d a l a m


t e r s e b u t .

4 S e l e s a 1 n r o s e s i n n d a n a t d i a m h i !

o a d a l o k e t D e n c a m b i l a n



3 ( t i g a ) h a r i k e i j a d a r i b e r k a s

p e r m o h o n a n d i t e n m a l e n g k a p d a n


5. B i a y a / t a r i f f R p . 0 ,-

6. P r o d u k p e l a v a n a n S K






8. K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 , S I

9, P e n g a w a s a n i n l e r n a l R a p a t s t a f s c l i a p b u l a n , L a p o r a n m e l a l u i


10 P e n a n g a n a n


m a s u k a n

• I ' c i i g u a u a n a o i a n g K CzywvutsrponmlkjihgfedcbaTSRPKJGA ufwri r a i

p e r s i l a h k a n m a s u k k e r u a n g K b u s u s


s o l u s L o l e h p e t u g a s p e n e r i m a

p e n g a d u a n .


-19-

I f n U PT k N F N zywvutsrponmlkjihgfedcbaTSRPKJGAn\JwnzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA r \ J n b 11 I I R A T A N

B nXVUTOLKJIHFDCB V TyvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA TLr# ^ r>ywtronmjfZWVMKJFA A o n o V T T B V T n o n fVr o f

s t i m i x , w e u , u a i i s i i i s u c r i K a n l u i m a i


n P M P r q P d o n n k A n d i h A l f l< 4 d e n t > A n

s o l u s i a d u a n . J * .

12. J a m i n a n p ^ . l E i v a n a n S O P , G r a t i s




a c p t v , M e j a h e l p d e s k , C C T V

14. E v a l u a s i k i n e i j a

p e i a k s a n a


1 3 . J e nl f l P c Uy an aa I z i n t e rhadap I nst o l at ur K z be l

R uDuh /Oc d un g ( I K R /G) .


1. D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n

B o v o l a l i N o m o r 1 3 T a h u n 2 0 1 1

t e n t a n g R e l n b u s i P e n z m a n T e r t e n l u .

• P e r a i u r a n D a e r a h K a b u p a t e n


l e n t a n g P c l a y a n a n P e n z i n a n d a n N o n


B o y o l a l i ,




K a b u p a t e n B o y o l a l i N o m o r 4 T u h u n

2 0 1 2 t e n t a n g P e l a y a n a n P e n z i n a n


K a b u p a t e n B o y o l a i i


b F o t o c o D V K T P P e m o h o n vane m a s i h r m ^•m' m T _r^_ n^/M Bi r w b b b b m m^ b b b a—r ^ b T_r b • j • b • b h— ^ m mm m m.^^ ^ m

b e r l a k u s u a m i / i s t r i W N A )



d . M a i c r a i R p . 6 0 0 0 , - ;

e. P a s f o t o b e r w a m a s e t e n g a h b a d a n






g . N e r a c a p e r u s a h a a n . s u s u n a n


h . S u r a t I z i n d a r i p i m p i n a n b a g i T N I ,

P O L R I a l a u P N S ;

i . R e k o m e n d a s i d a r i I n s t a n s i t e k n i s

y a n g t e r k a i t ;

j . M e l a m p i r k a n S l U P A s h , b a g i


u l a n g , p e r u b a h a n a t a u p e n g g a n t i a n .


p r o s e d u r

L P e m o h o n d a p a t m e n g a m b i l



-20-


4


m a u p u n W e b r e s m i D P M P T S P . ywtronmjfZWVMKJFA

2. S e t e l a h b l a n g k o d i i s i d a n p > e m y a t a a n






3 . P r o s e s :


m e n i n d f t k 1 a n i l I t 1 n ^ r m * ^ h n n a n

t e r s e b u t .


<] Q j ' l f C a i n r / ^ Q fQ l l i n Hunrar a i n r n V r i l

^ . o c i c a d i p iXVUTOLKJIHFDCB L } ? H. ?> ij l i 1 u a p a i [J i f i T o o n

n a d a I n k e l t i e n f a t i i b i l n n

4 ^ l a n g k a w a k t u




b e n a r o l e h v e n f i k a t o r

5 . 0 i a v a / t a r i IT RD 0 -

6 . P r o d u k p e l a y a n a n 5 K

7 . S a r a n a o r a s a r a n a


M e i a k u r s i c o m n u t e r P r i n t e r


s m s s c i v j c e , g p s , A T K d a n m o b i l .

8 K ^ ^ m p c t e n s i p e i a k s a n a D i k i a i P T S P , S M A / D 3 . S I .

9 . P e n g a w a s a n i n t e m a l R a p a t s l a f a e l t a p b u l a n . l a p o r a n m e l a J u i




m a s u k a n





o e n c a d u a n

> P e n g a d u a n d a p a t m e l a l u i k o t a k


T e r t e n t u k c n o m o r p e n g a d u a n



1 1 J u m l a h DC l a k S a n a 4 u r a n g .

1 2 . J a m i n a n p e l a y a n a n SOP, G r a t i s

1 3 .

1 4

J a m i n a n k e a m a n a n d a n

k e s e l a m a t a n p c l a y a n a n


a c , l v , M e j a h e l p d e s k , C C T V

1 3 .

1 4 E v a l u a s i k i n e r j a

p e i a k s a n a


1 4 . J e n U P e Uy anan I z l n K ant o r Cabang dan L o k e t P e l ay anan

Ope rat o r

NO K OMPONEN L H A I A N

L D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i

N o m o r 1 3 T a h u n 2 0 1 1 i c n l a n g


• P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a i i


P e l a y a n a n P e n z i n a n d a n N o n

•21-



B o y o l a l i ,


fXVUTOLKJIHFDCB 4 1 1 I U I IzywvutsrponmlkjihgfedcbaTSRPKJGA z\j i t T n a n g r c i u n j U K



2 0 1 2 t e n t a n g P c l a y a n a n P e r i z i n a n d a n

n o n P e n z i n a n T e r p a d u K a b u p a t e n

B o y o l a l i



b e r l a k u j j i k a s u a m i / i s t r i W N A )

m e l a m p i r k a n F o l c x r o p y P a s p o r ;

c . F o t * > c o p y N P W P ;

d . M a t e r a i R p . 6 0 0 0 . - ;

e . P a s f o t o b e r w a m a s c t e n g a h b a d a n


f. S u n i t I z i n d a n p i m p i n a n b a g i T N I .

P O L H I a t a u P N S ;




h u k u m ;

h . N e r a c a p e r u s a h a a n , s u s u n a n


i . S u r a t P e n u n j u k a n / P e n e t a p a n

s e b a g a i k a n t o r c a b a n g d a n l o k e t

p e i a \ a n a i i o p c r a t t > r .

j . R e k o m e n d a s i d a r i I n s t a n s i t e k n i s

y a n g t e r k a i t ;

k . M e l a m p i r k a n S l U P A s l i , b a g i p e m o h o n

y a n g m e l a k u k a n d a f t a r u l a n g ,

p e r u b a h a n a t a u p c n g g a n t j a n .

3. S i s t e m , m e k a n i s m e . d a n

p r o s e d u r

K P e m o h o n d a p a t m e n g a m b i l











3 . P r o s e s :


m e n m u a K j a n j u u p e r r n o n u r i a n

t e r s e b u t .

• M e l a k u k a n p e m e r i k s a f l n l o k a s i .

4 S e l e s a i o r o s e s i n n d a o a i d i a m b i l


4 , J a n g k a w a k t u





-22-

NO K OMPONEN URAIAN 5 E i av a/zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA l a r i f T yvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA

iâ yywtronmjfZWVMKJFA AM J ^ ' mA 4

R n 0 -

6. Produk p e l a y a n a n S K 7 * - O a l ( iJ l a . p i a n t i J d J JQ

d a n / a t a u f a s i L L l a s

mcja, K u r s j , c f j m p u i c r . r n n i c r ,

I n t e m e t / A p l i k a s i s i s t e m / W e b / E m a i l ,


8 K o m p e t e n s i p e i a k s a n a D i k l a t P T S P . S M A / D 3 . S I .

9. P e n g a w a s a n i n i r i r i . i ! R a p a l s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i


10. P e n a n g a n a n


m a s u k a n

• P e n g a d u a n d a t a n g k e D P M P T S P di




1 L g dU U a J L.

• r c n g a o u a n a a p a t m e i a J u i K o t a k E l F X E ' F X E l p jm. L f A j—L VB B-L BB J- BT XVJ—B _ ' A B—L B-B-B-B J—L A

s a r a n , w e o , o a n s m s d e n g a n l o r m a t


J - J r i v j r l o r [ I ' l l I d i u i i X u i u a i d S Q c n g c U l

s o l u s i aduan. 1 1 A t ^

l i u m l a h n e l a k s a n a 4 o m n c T 4_ r j C I J J O L r

12- J a m i n a n p e l a y a n a n S O P , O r a u s


k e s e l a m a i j i n p < ' l H i v a n a n

N o m o r a n t r i a n d a n m a n g t u n g g u b e r


14. E v a l u a s i k i n e r j a

p e i a k s a n a


1 5 . J e n i a P c l ay anan I x i n Gnl l an n n t ak ke pe r luan pengge laran

kabe l t e l e k o m unl k aai dalam oatu K abupat e n-

NO K O M P O N E N URAIAN


a i y o l a l i N o m o r 1 3 T a h u n 2 0 1 1




l e n t a n g P c l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,


T a h u n 2 0 1 3 l e n t a n g P e t u n j u k



2012 t e n t a n g P c l a y a n a n P e n z i n a n



2. P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n k o S u r a l P e r m o h o n a n ;


b e r l a k uzywvutsrponmlkjihgfedcbaTSRPKJGA ijika s u a m i / i s t r i W N A )



d. M a t e r a i R p . 6 0 0 0 , - ;

c. P a s f o l o b e r w a m a s c t e n g a h b a d a n


f. S u r a l I z i n d a r i p i m p i n a n b a g i T N I ,

P O L R I a l a u P N S ;

g . F o i o c o p y s a h A k t e

-2 J -







i . P e i a L o k a s i P e n g g e l a r a n K a b e l ;

j . S u r a l P e m y a t a a n K e s c d i a a n

m e m p e r b a i k i b a n g u n a n / j a l a n y a n g

d i p e r g u n a k a n u n t u k p e n g g e l a r a n

k a b e l k e k o n d i s i s e m u l a ;

k . S u r a l P e m y a t a a n P e n g g u n a a n

J a r i n g a n K a b e l b e r s a m a ;

\. R e k o m e n d a s i d a r i I n s t a n s i t e k n i s

y a n g t e r k a i t ; '

m . M e l a m p i r k a n 5 I U P A s l i , b a g i


u l a n g . p e r u b a h a n a t a u p e n g g a n t i a n .


p r o s e d u r

1. E V m o h o n d a p a t m e n g a m b i l






L e n g k a p o l e h p e m o h o n d a p a t





3 . P r o s e s :

* P e m b a h a s a n / k a j i a n d a l a m


t e r s e b u t .




4, J a n g k a w a k c u


7 ( t u j u h ) h a n k e r j a d a r i b e r k a s



5. B i a y a / t a r i f f Rp. 0 ,-

6 . P r o d u k p c l a y a n a n S K




[ n t c m e i / A p l i k a s i s i s t e m / W e b / E m a i l ,


8. K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 , S I

9. P e n g a w a s a n i n t e r n a l Rapat s t a f s e t i a p b u l a n , L a p o r a n m e l a l u i


10- P e n a n g a n a n


m a s u k a n



P e n g a d u a n d a n d i f a s i l n a s i d e n g a n


p e r i g a d u a n .


s a r a n , w e b , d a n a m s d e n g a n f o r m a t

•24-

NO XVUTOLKJIHFDCB1 4 X /

K OMPONEN zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAI I P A T A N

t e r t e n l u k e n o m o r p e n g a d u a n n P M P T ^ P H a nzywvutsrponmlkjihgfedcbaTSRPKJGA a\tan Hi K a l ' j v H ^ n c r a n

L ^ i ^ i v i n o r u a i i a r u i n u i D a j a s u c n g a n

s o l u s i aduan. 1 1 u u J 1 1 j u IL t ê i i uOMi i j a •f o r a n g -

1 2 . J a m i n a n p c l a y a n a n S O P , G r a t i s



N o m o r a n t r i a n d a n ruang tunggu b e r

ac . t v , Meja help desk, C C T V


p e i a k s a n a

IKM t i a p 6 b u l a n .

1 6 . J C D I B P e l ay anan I z l n Usaha Wani ng I n t e rne t dan Game-Ne t .

NO h O M i Y J N E N U R A I A N


B o y o l a l i N o m o r 1 3 T a h u n 2 0 1 i




l e n t a n g P e l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,


T a h u n 2 0 1 3 l e n t a n g E V t u n j u k





K a b u p : i r r - n B o v o l a l i




m e l a m p i r k a n F o t t i c o p y P a s p o r ;

c - F o t o c o p y N P W P ; H M a t F T n i P n 6 0 0 0 u . m a i c i a i i ^ p . L J * - " - ' u , .

c . P a s f o t o b e r w a r n a s e t e n g a h b a d a n







h . S k e m a R e n c a n a T a p a k d a n J a r i n g a n

P e r s o n a l K o m p u t e r ;

i - S u r a l P e m y a t a a n k e s c d i a a n

m e l a k s a n a k a n k e l e n i u a n t e k n i s ,

m e n j a g a n o r m a s u s i l a , a g a m a s e s u a i

k e t e n l u a n p c r u n d a n g - u n d a n g a n

v a n g b e r l a k u ;

j . F o t o c o p v A M D A L / U K L / U P L / D P P L /

S P P L ;

k . R e k o m e n d a s i I n s t a n s i T e k n i a y a n g

t e r k a i i .

3 . S i s t e m . m e k a n i s m e , dan

p r o s e d u r

a. P e m o h o n d a p a t m e n g a m b i l /



-25-




b . S e t e l a h b l a n g k o d i i s i d a n p e m y a t a a n





L A - XVUTOLKJIHFDCB1zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA ivj a l l ciJ d J J .

c . P r o s e s p e m b a h a s a n / k a j i a n d a l a m


l e r s e b u f

H S e l e s a i o r o s e s i i i n d a n a f d i j i m b i l


4. J a n g k a w a k l u





5 - Biav f l/ L a r i f i ^ — ^»

6 . Produk p e l a y a n a n S K

7 S a r a n a o r a s a r a n a


M e i a I t u r s i r o m n i i i r r P r i n t e r

4 " I ^ J O JywtronmjfZWVMKJFA J n u L p L ^ 4 _ / m I A L J KM L V r I p ± 4 1 1 1 1 |

I n i c m e i / A p l i k a s i s i s t e m / W e b / E m a i l ,

s m s s e r v i c e , g p s , A T K d a n m o b i l . 8 . K o m p e t e n s i p e i a k s a n a D i k l a t F T S P . S M A / D 3 , S I .





m a s u k a n





D c n e a d u a n

* P e n g a d u a n d a p a t m e l a l u i k o t a k



D P M F T S P d a n a k a n d i b a l a s d e n g a n


1 1

A a • l i u m l a h o e l a k s a n a 6 o r a n H .

1 2 . J a m i n a n p e l a v a n a n S O P , G r a t i s



N o m o r a n t r i a n d a n r u a n g t u r ^ u ber



p e i a k s a n a


1 7 . J e n i s P c Uy sDan I z l n R um ah Sak i t Um um T y pe C , D.


1. D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i




N o m o r 4 T a h u n 2 0 1 2 t e n t a n g

P e l a y a n a n P e r i z i n a n d a n N o n P e n z i n a n

T e r p a d u K a b u p a t e n B o y o l a l i ,




-26-

NO KOMPONKN zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAU R A I A N

K a b u p a t e n B o y o l a l i N o m o r 4 T ahun

2 0 1 2 ( e n t a n g P c l a y a n a n P e r i z i n a n d a n


B o y o l a l i

2 , P e r s a y a r a t a n P c l a y a n a n ( 1 | I z i n P e n d i r i a n

a . M e n g i s i B l a n k o P e r m o h o n a n ;




c- F o i o c o p y N P W P :

d . M a t e r a i R p . b O O O . - ;

e . P a s f o i o b e r w a m a s c t e n g a h b a d a n


f. F o t o c o p y S e r l i r i k a i / B u k l i

k e p e m i l i k a n t a n a h d a n a t a u S K P P T ; zywvutsrponmlkjihgfedcbaTSRPKJGA

g. F o i o c o p y s a h A k t e

P e n d i r i a n / P c r u b a h a n n y a y a n g


b e r b a d a n h u k u m :

h . F o i o c o p y I z i n P r i n s i p ;

L. F o i o c o p y 1 M B ;

J . S t u d y K e L a y a k a n ;

k. M a s t e r P l a n ;

1. F o t o c o p y

A M D A L / U K L / U P L / D P P L / S P P L / A N

D A L A L I N ;

m . R e k o m e n d a s i I z i n M e n d i r i k a n d a r i

i n s t a n s i t e k n i s t e r k a i t .

( 2 ) I z i n U p e r a s L o n a L



b e r l a k u \jika s u a m i / i s l r i W N A )



d . M a t e r a i R p . 6 0 0 0 , - ;

e . P a s f o t o b e r w a m a s e t e n g a h b a d a n


f. F o t o c o p y [ z i n P e n d i r i a n ;

g . D a f t a r I n v e n t a r i s s a r a n a p r a s a r a n a ;

h . D a f l a r I n v e n t a r i s P c r a l a t a n

K e s e h a t a n ;

i . N e r a c a , S l r u k t u r O r ^ a n i s a s i d a n

d a f l a r k e t e n a g a a n ( t e n a g a m e d i s ,

p a r a m e d i s , t e n a g a k e s e h a t a n

l a i n n y a d a n l e n a g a a d m i n i s t r a s i ) ;

j . R e k o m e n d a s i d a r i I n s l a n s i t e k n i s

t e r k a i t .

3 . Si st em, m e k a n i s m e , d a n

p r o s e d u r

1. Pemohon d a p a l m e n g a m b i l

/ m e n d o w k i a d b l a n g k o s e s u a i



m a u p u n W e b r c s m i D P M P T S P .


-27 -







3 . P r o s e s :


m e n i n d a k I Ji n iXVUTOLKJIHFDCB 1 1 f i n e r m t i b n n n n J 111.1111 I U 4 m L c l 11J L I U L^CL 1 I I U J J U I i d l l

t e r s e b u t .


4 S e l e s a i m r o s e s 1 1 i n d a n a i d i a m h i l

D a d a l o k e t n c n c a m b i l a n zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBAu - h A X d L XMJH MywtronmjfZWVMKJFA %j^m-\M \ " J ^ 4 - A • 4 * ^ x i I A A A 4 •





b e n a r o l e h v e r i f i k i i t o r

5 . B i a y a / t a r i f T RD 0 -



d a n / a t a u f a s i l i t a s I n t e r n e t / A p l i k a s i s i s t e m / W e b / E m a i l ,

sm s s e r v i c e , g p s , A T K d a n mobU-

R. ' K o m p e t e n s i p e i a k s a n a D i k l a f P T ^ P , S M A / D 3 , S i .

9 . P e n g a w a s a n i n t e r n a l R a p E k i s t a f s r t i a p b u l a n . l a p o r a n m e l a l u i

a p J i k a s i s i s l e i n ,



m a s u k a n

• I V n g a d u a n d a t a n g k e D P M P T S P d i




o e n p a d i i a n zywvutsrponmlkjihgfedcbaTSRPKJGA

t P e n p a d i i r t n H a r j a l m e l n l i i i k o t a k

s a r a n w e b d a n s m s d e n f f a n f o r m a t




1 1 . J u m l a h p e i a k s a n a f t o r a n g AM \Mm T i l l r

1 2 . J a m i n a n p c l a y a n a n S O P . G r a t i s






1 p e i a k s a n a


1 8 . J e n U Pe l ay anan I z i n R um ah Sak i t K h usua T y pe C.

NO K O M l ^ > N E N U R A I A N

I . D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i

N o m o r 1 3 T a h u n 2 0 1 i t e n t a n g

R e t r i b u s i P e r i z i n a n T e r t e n l u .


N o m o r 4 T a h u n 2 0 1 2 I c n l a n g

P e l a y a n a n P e r i z i n a n d a n N o n P e n z i n a n

T e r p a d u K a b u p a t e n B o y o l a l i ,


T a h u n 2 0 1 3 t e n l a n g P c l u n j u k


-24-

N O K O M P O N E N U R A I A Nr 1 K a b u p a t e n B o y o l a U N o m o rzyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA 4 T a h u n

2 0 1 2 l e n t a n g P e l a y a n a n P e r i z i n a n d a n


B o y o l a l i

2 . Persay arat an Pe layanan ( 1 ) I z i n P e n d i r i a n

a. M e n g i s i B l a n k o P e r m o h o n a n ;

b. F o t o c o p y K T P P e m o h o n y a n g m a s i h

b e r l a k u Q i k a s u a m i / i a l r i W N A |



d . M a t e r a i R p . 6 0 0 0 , - ;

c . P a s f o t o b e r w a m a s c t e n g a h b a d a n


f . F o t o c o p y S e r t i f i k a l / B u k t i

k e p e m i l i k a n t a n a h d a n a t a u S K P P T ;

R F o i o c o p y s a h A k t e

P e n d i r i a n / P e r u b a h a n n v a v a n e



h . F o t o c o p y I z l n P r i n s i p ;

i . F o t o c o p y 1 M B ;

j S t u d y K c l a y a k a n ;

M a s t e r P l a n ;

1. F o t o c o p y

A M D A L / U K L / U P L / D P P L / S P P L / A N

D A U L I N ;

m R e k o m e n d a s i I z i n M e n d i r i k a n d a r i

i n s t a n s i t e k n i s t e r k a i t .

| 2 } I z i n O p e r a s i o n a l


F o t o c o p y K T P P e m o h o n y a n g m a s i h




d . M a t e r a i R p . b O O O , - ;

c . P a s f o t o b e r w a m a s e t e n g a h b a d a n

u k u r a n 4 X 6ywtronmjfZWVMKJFA 2 ( d u a ) l e m b a r ;

f. F o i o c o p y [ z i n P e n d i r i a n ;

R D a f l a r I n v e n t a r i s s a r a n a p r a s a r a n a ;

h. D a f l a r I n v e n t a r i s P e r a l a i a n

K e s e h a t a n ;

i . N e r a c a , S l r u k t u r O r g a n i s a s i d a n

d a f t a r k e t e n a g a a n ( t e n a g a

m e d i s / k h u s u a , p a r a m e d i s / k h u s u s .

t e n a g a k e s e h a t a n l a i n n y a d a n

t e n a g a a d m m i s t r a s i } ;

j - R e k o m e n d a s i d a r i I n s t a n s i t e k n i s j -t e r k a i t .

3 . Si st em, mekani sme , dan L P e m o h o n d a p a t mengambi l

p r o s e d u r / m e n d o w l o a d b l a n g k o s e s u a i p r o s e d u r


-29-

N O K O M P O N E N U l i A I A N





d i k c m t > a l L k a n u n t u k d i d a f t a r




3 . P r o s e s : zywvutsrponmlkjihgfedcbaTSRPKJGA

m r CzyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA J J L U t l l l u b l u l 1 / l U l l l d l l U c U a J I J


t e r s e b u t

4 M e l a k u k a n o e m p r i k s j i n n l o k a s i

4 S e l e s a i n r c i s c s i n n d a r u i l d i a m b i l

o a d a l o k e t o e n G a m b i l a n B_rB_B T • • • B T—T B B B Bf k • B HB B-B B B B XX B BX^ I I H 4. J a n g k a w a k t u


7 ( l u j u h l h a n k e r j a d a n b e r k a s


I x T i a r o l e h v e r i f i k a f o r MJH

• J . L J i c t ' a / i d i 111

6 . P r o d u k p e l a v a n a n SK

7. S a r a n a o r a s a r a n a B_rEf • LB • BV-B % • LB BV—B a •_• a BB-B


M e i a k u r s i c o m o u t e r P r i n t e r

I n l e m e l / A p l i k a s i s i s l e m / W e b / E m a i l ,


8 . K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S H A / D 3 . S I ,

9 . P e n g a w a s a n i n t e m a l R u p a t s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i


1 0 . P e n a i ^ a n a n


m a s u k a n





n e n c a d u a n BX^^ M M H L L B X H 1—BH—L• MywtronmjfZWVMKJFA m

• P e n g a d u a n d a i ^ t m e l a l u i k o t a k w B B B HBBHXH WBBH a B X n WB BBVB B I B • Xr r w H a WB B BBBX XHiHa B

s a r a n w e b d a n s m s d e n i z a n f o r m a t B_4.h_B BiB.X LB • 4 Xj" L X B XHB^LB a BX B • a XX XB XJ- L BVÂHB a a L X X • BBBH B



s o l u s i a d u a n 1 1 . J u m l a h p e i a k s a n a 6 o r a n g -

1 9 1 A m i n A TI I ' v l A V & n f l r i S O P O r a l i s


k c s e L a m a t a n p c l a y a n a n

N o m o r a n t r i a n d a n r u a n g l u n g g u b e r

a c . t v , M e j a h e l p d e s k . C C T V

14, E v a l u a s i k i n e r j a

p e i a k s a n a


1 9 . J e n U PcUy oDOi i I z i n K l i n i k P rat am a.

N O K O M K ) N E N U R A I A N


B o y o l a l i N o m o r 1 3 T u h u n 2 0 1 1

t e n t a n g R c t n b u s i P e r i z i n a n T e r t e n l u ,



l e n l a n g P e l a y a n a n P e r i z i n a n d a n N o n

P e r i z i n a n T e r p a d u K a b u p a l e n

B o y o l a l i ,

-30-


• P e r a t u r a n B u p a t i B o y o l a i i N o m o r 1 0



K a b u p a t e n B o y o l a i i N o m o r 4 T a h u n




2 . P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n k o P e r m o h o n a n ; zywvutsrponmlkjihgfedcbaTSRPKJGA

b. F o t o c o p y K T P P e m o h o n y a n g m a s i h

b e r l a k u ijika s u a m i / i s t r i W N A )



d . M a t e r a i R p , 6 0 0 0 , - ;


u k u r a n 4 X 6 2 ( d u a ) l e m b a r

f. F o t c x r o p y s a h A k t e




g . F o t o c o p y [ M B ;

h . F o t o c o p y

A M D A L / U K L / U P L / D P P L / 3 P P L ;

i . R e k o m e n d a s i d a r i i n s t a n s i t e k n i s

t e r k a i t ;

j . D a f t a r I n v e n t a r i s s a r a n a p r a s a r a n a ;

k . D a f t a r I n v e n t a r i s P e r a l a i a n

K e s e h a t a n ;

1- N e r a c a , S t r u k l u r O r g a n i s a s i d a n

d a f l a r k e t e n a g a a n ( t e n a g a m e d i s ,

p a r a m e d i s , l e n a g a k e s e h a t a n l a i n n y a

d a n t e n a g a a d m i n i s t r a s i ) .


p r o s e d u r





m a u p u n W e b r c s m i D P M P T S P ,





s e l a n j u m y a d i b e r i t a n d a b u k t i


3 . P r o s e s :



t e r s e b u t ,

* M e l a k u k a n p e m e r i k s a a n l o k a s i .







b e n a r p a d a r u a n g i n f o r m a s i . zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

- 3 b

N O K O M P O N E N U R A I A N zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBAV iywtronmjfZWVMKJFA m-K4 \* 1 5 - B i a v a / l a n f T

••B* X 4-4 r BXMJH HW W + + 4

R p 0 -

6 , P r o d u k p c l u v a n a n S K

7 - Sarana. p r a s a r a n a


M e i a . k u r s i . c o m p U E e r P r i n t e r



K t m i p e i e n s i p e i a k s a n a D i k l a t P T S P . S M A / D 3 , S L




p e n g a d u a n , s a r a n . d a n

m a s u k a n





p e n g a d u a n .

• P e n v a d u a n d a o a t m e l a l u i k o i a k

s a r a n , w e b , d a n s m s d e n c a n f o r m a t


D P M P T S P d a n a k a n d i b a l a s d e n s a n ™ ~ r • ^-'^ • • 4 4 • • 4 * ^—'XX*XXX» XH Xr • • H^^HH X

s o l u s i a d u a n . U - J u m l a h p e i a k s a n a

X r X n v • B v X n 4 W mr X r v X ^ v X X r X ^ L H H X n

6 o r a n e .




N o m o r a n t r i a n d a n r u o n g t u n g g u b e r



p e i a k s a n a

IKM t i a p b b u l a n .

2 0 , J e n U Pe Uy m ni n I x i n K l l n l k UUm a .




t e n t a n g R e t r i b u s i P e r i z i n a n T e r t e n t u ,



t e n l a n g P e l a y a n a n P e n z i n a n d a n N o n

P e n z m a n T e r p a d u K a b u p a t e n

B o y o l a l i ,

« P e r a t u r a n B u p a t i B o y o l a l i N o m o r 1 0



K a b u p t i l e n B o y o l a l i N o m o r 4 T a h u n




2 . E^rsay arai an I V lay anan a , M e n g i s i B l a n k o P e r m o h o n a n ;

b - F o t o c o p y K T P P e m o h o n y a n g m a s i h


m e l a m p i r k a n F o t o c o p y P a s p o r ; zywvutsrponmlkjihgfedcbaTSRPKJGA


d . M a t e r a i R p . 6 0 0 0 . - ;

e. P a s f o t o b e r w a m a s e t e n g a h b a d a n


f . F o i o c o p y ftuh A k t e




-32 -

N O K O M P O N E N zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBAU R A I A N


h . F o i o c o p y

A M D A L / U K L / U P L / D P P L / S P P L ;

i . R e k o m e n d a s i d a r i i n s t a n s i t e k n i s

t e r k a i t ;

j . D a f t a r I n v e n t a r i s s a r a n a p r a s a r a n a ;

k . D a f t a r I n v e n t a r i s P c r a l a t a n

K e s e h a t a n ;

1. N e r a c a , S l r u k t u r O r g a n i s a s i d a n

d a f t a r k e t e n a g a a n ( t e n a g a m e d i s d a n

t e n a g a s p e s i a l i s , p a r a m e d i s , l e n a g a

k e s e h a t a n l a i n n y a s e r t a t e n a g a

a d m i n i s t r a s i j .

3 , S i s l e m , m e k a n i s m e . d a n

p r o s e d u r












3 . P r o s e s :



t e r s e b u t .

* M e l a k u k a n p e m e r i k s a a n l o k a s i ,



4 J a n g k a w a k t u


7 ( l u j u h j h a r i k e r j a d a r i b e r k a s



5 . B i a y a / t a r i f T R p . 0 , -

6F P r o d u k p e l a v a n a n SK

7 . S a r a n a n r a s a r a n a X_#4iH • VLB I X H 1 X r I X n S_r% "iywtronmjfZWVMKJFA W X X W X X n


M e j a , k u r s i . c o m p u t e r , P r i n t e r ,



8. K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 . S l .

9 .

1 0 7

P e n g a w a s a n i n t e r n a l R a p a l s t a f s e u a p b u l a n , l a p o r a n m e l a l u i


9 .

1 0 7 P e n a n g a n a n


m a s u k a n





p e n g a d u a n .



l e n c n l u k c n o m o r p e n g a d u a n

-33-




1 1 . J u m l a h p e i a k s a n a 6 o r a n g . zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

12. J a m i n a n p e l a v a n a n S O P . G r a t i s


k c s e l a m a I a n p e l a v a n a n

N o m o r a n t r i a n d a n r u a n g t u n g g u ber



p e i a k s a n a


2 1 . J e n U Pe l ay anan T anda Daf t ar I nduat rL

N O

2 .

K O M H J N E N

D a s a r H u k u m

U R A I A N

P e r s a y a r a t a n P e l a y a n a n

P e r a t u r a n D a e r a h K a b u p a t e n


t e n l a n g R e t r i b u s i P e r i z i n a n T e r t e n l u .



l e n t a n g P e l a y a n a n P e n z i n a n d a n N o n


B o y o l a l i ,

P e r a t u r a n B u p a t i B o y o l a l i N o m o r I D

T u h u n 2 0 1 3 t e n t a n g P e t u n j u k



2 0 1 2 t e n l a n g P e l a y a n a n P e n z i n a n



a .

b .

c .

d .

e .

f.

8 -

h .

I .

M e n t a l B l a n k o P e r m o h o n a n ;

F o t o c o p y K T P P e m o h o n y a n g m a s i h

b e r l a k u [ j i k a s u a m i / i s t r i W N A )


F o t o c o p y N P W P ;

M a i c r a i R p . 6 0 0 0 , - ;

P a s f o t o b e r w a r n a s e t e n g a h b a d a n


F o t o c o p y s a h Akte



b e r b a d a n b u k u m ;

F o i o c o p y 1 M B ;

N e r a c a p e r u s a h a a n ( m o d a l d i b a w a h

R p . 5 0 J u t a ) . s u s u n a n p e n g u r u s d a n

p e m e g a n g s a h a m ;

F o t o c o p y

A M D A L / U K L / U P L / D P P L / S P P L .

3 . S i s l e m , m e k a n i s m e , d a n

p r o s e d u r

2 ,

P e m o h o n d a p a l m e n g a m b i l





S e t e l a h _ b i a n g k Q d i i s i d a n p e m y a t a a n

-34-




s e i a n j u t n y a d i b e n t a n d a b u k t i


3 . P r o s e s :

* P e m b a h a s a n / k a j i a nzyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA dalam

m e n i n d a k l a n j u t i o e r m o h o n a n

t e r s e b u t .


4. S e l e s a i p r o s e s i j i n d a p a l d i a m b i l


4. J angka w a k t u





5 . B i a y a / t a r i f f R p . 0 ,

6. P r i x l i i k p H i L \ a n a n SK

7. -

S a r a n a , p r a s a r a n a



I n l e m e l / A p l i k a s i s i s t e m / W e b / E m a i l ,


8 . K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 . 3 1 .



1 0 . P r i i a n g a n a n


m a s u k a n



i * c n g a d u a n d a n d i f a s i l i t a s i d e n g a n


T K n e a d u a n .

• P e n E a d u a n d a o a t m e l a l u i k o t a k





1 1 . J u m l a h p e i a k s a n a 6 o r a n g .

1 2 . J a m i n a n p c l a y a n a n S O P , G r a t i s

1 3 . J a m i n a n k e a m a n a n d a n N o m o r a n t r i a n d a n r u a n g t u n g g u b e r

k e s e l a m a t a n n e l a v a n a n , a c . t v , M c i a h e l p d e s k , C C T V

14. E v a l u a s i k i n e i j a

p e i a k s a n a


2 2 . J e n l B Pe lay ao ai i I z l n U u h a P e t e rnakan.


1. D a s a r H u k u m » P e r a t u r a n D a e r a h K a b u p a t e n


t e n t a n g R e t r i b u s i P e n z m a n T e r t e n t u ,

• P e r a i u r a n D a e r a h K a b u p a l e n


i c n l a n g P c l a y a n a n P e r i z i n a n d a n N o n

P e n z m a n T e r p a d u K a b u p a t e n

B o y o l a l i ,




K a b u p a t e n B c J v o l a l i N o m o r 4 T a h u n

-55-



d a n n o n P c r i z m a n T e r p a d u

K a b u p a t e n B o y o l a J i

2 . P e r a a y e r a t a n P e l a y a n a n a . M e n g i s i B l a n g k c i P e r m o h o n a n ;


b e r l a k u ( j i k a s u a m i / i s t n W N A )



d . M a t e r a i R p . 6 0 0 0 . s



f. F o i o c o p y 1 M B ;

g. F o t o c o p y S e r t i f i k a t / B u k t i

k e p e m i l i k a n t a n a h d a n a t a u S K P F T ;

h . F o t o c o p y s a h A k t e



b e r b a d a n h u k u m ; zywvutsrponmlkjihgfedcbaTSRPKJGA

i. N e r a c a p e r u s a h a a n , s u s u n a n


J . B e r i t a A c a r a S o s i a l i s a s i w a r g a

s e k i l a r d i k e t a h u i K e l u a R T , R W d a n

K a d c s / L u r a h ;

k . S u r a l P e m y a t a a n / P e r s e t u j u a n

L i n g k u n g a n s e k i t u r y a n g d i k e t a h u i

K e t u a R T , R W d a n K a d e s / L u r a h

s e t e m p a t ;

1 D e n a h l o k a s i t e m n a l u s a h a *

m , F o t o c o p y


n - R e k o m e n d a s i d a r i i n s t a n s i t e k n i s

t e r k a i t ;


p r o s e d u r



k e b u i u h a n y a n g j u g a i c l u h



2. S e t e l a h b l a n g k o d i m d a n p e m y a t a a n

i e n g k a p o l e h p e m o h o n d a p a t

d i k e m b a l i k a n u n l u k d i d a f t a r


s e i a n j u t n y a d i b e r i t a n d a b u k l i


3 . P r o s e s :


m e n i n d a k l a n i u 11 o e r m o h o n a n

t e r s e b u L

• M e l a k u k a n p e m e r i k s a a n l o k a s i





7 { t u j u h ) h a r i k e r j a d a r i b e r k a s



3 * .


5 . B i a v a / l a r i f T zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA• 1

R p . 0 . -

6, P r o d u k p e l a y a n a n SK



M e j a . k u r s i , c o m p u t e r . P r i n t e r ,



Kompetensi p e i a k s a n a D i k l a t P T S P , S M A / D 3 , S i .

9 . P e n g a w a s a n i n t e r n a l R a p a t s l a f s c l i a p b u l a n , l a p o r a n m e l a l u i




m a s u k a n

• P e n g a d u a n d a i a n g k e D P M P I ' S P d i




p e n g a d u a n .

• P e n t t a d u a n d a p a t m e l a l u i k o t a k V 9 4 • k X 4 • B X^4X4 4- 4 v 4 X 4 X r X 4 X • • • Xr bX nMJH M X r l • X_r XmH4 X

s a r a n , w e h , d a n s m s d e n g a n f o r m a l

t c r l c n i u k e n o m o r p e n g a d u a n

D P M P T S P d a n a k a n d i b a l a a d e n g a n

s o l u s i a d u a n 11, J u m l a h p e i a k s a n a 6 o r a n g .

12- J a m i n a n p e l a y a n a n S O P . G r a t i s



N o m o r a n t r i a n d a n r u a n g l u n g g u ber

a c , i v , M e i a h e l p d e s k , C C T V


p e i a k s a n a

I K M t i a p b b u l a n .

2 3 . J e n i a P e l ay anan l a i n Pe r lo aaan Uaaha P e t e m ak an

N O K H M P t l N E N U R A I A N

1. D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a l e n



• P e r a i u r a n D a e r a h K a b u p a l e n


I c n l a n g P e l a y a n a n P e n z i n a n d a n N o n

P e n z i n a n T e r p a d u K a b u p a l e n

B o y o l a l i ,



P e l a k s a n a a n P e r a i u r a n D a e r a h

K a b u p a l e n B o y o l a l i N o m o r 4 T a h u n

2 0 1 2 l e n t a n g P c l a y a n a n P e r i z i n a n


K a b u p a l e n B o y o l a l i

2. P e r s a y a r a t a n P c l a y a n a n a . M e n g i s i B l a n g k o P e r m o h o n a n ;


b e r l a k u ( j i k a s u a m i / i s l r i W N A |


c . F o i o c o p y N P W P :

d . M a i c r a i R p . b O O O . - ;

e . P a s f o l o b e r w a m a s e i e n g a h b a d a n



g . F o i o c o p y S e r t i f i k a l / B u k l i


-37-

N O K O M P O N E N U R A I A N 1

h . F o i o c o p y s a h A k t e






J . B e r i t a A c a r a S o s i a l i s a s i w a r g a

s e k i l a r d i k e t a h u i K e t u a K T , K W d a n

K a d e s / L u r a h ;

k - S u r a l P e m y a t a a n / P e r s e t u j u a n

L i n g k u n g a n s e k i t a r y a n g d i k e t a h u i

K e t u a E ^ , R W d a n K a d e s / L u r a h

s c t e m p a t ; zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

1. D e n a h l o k a s i t e m p a t u s a h a ;

m , F o i o c o p y


n . R e k o m e n d a s i d a r i i n s l a n s i t e k n i s

t e r k a i i ;


p r o s e d u r

L P e m o h o n d a p a l m e n g a m b i l




m a u p u n W e b r e s m i D P M P T S P . zywvutsrponmlkjihgfedcbaTSRPKJGA







3- P r o s e s ;



t e r s e b u t .

• M e l a k u k a n p e m e r i k s a a n

l o k a s i .

4. S e l e s a i p r o s e s i j i n d a p a t d i a m b i l

p a d a L o k e i p e n g a m b i l a n .

4. J a n g k a w a k l u

p e n y e L e s a i a n




5 . B i a y a / t a r i f T R p ^ 0 , -

6 . P r o d u k p c l a y a n a n S K

7 . S a r a n a u r a s a r a n a


M e i a , k u r s i . c o m o u t e r . P r i n t e r ,



8 . K o m p e t e n s i p e i a k s a n a D i k l a i P T S P , S M A / D 3 , S L

9,

l u .

P e n g a w a s a n i n t e r n a l R a p a l s l a f s e t i a p b u l a n , l a p o r a n m e l a l u i

a p l i k a s i s i s l e m .

9,

l u . P e n a n g a n a n


• P e n g a d u a n d a i a n g k e D P M P T S P d i

p e r s i l a h k a n m a s u k k e r u a n e K h u s u s

-1 8 -


m a s u k a n P e n g a d u a n d a n d i f a s i l i t a s i d e n g a n


p e n g a d u a n .








1 3 . J a m m a n k e a m a n a n d a n


N o m o r a n t r i a n d a n r u a n g t u n ^ u b e r

a c , t v , M e j a h e l p d e s k . C C T V


p e i a k s a n a


2 4 .zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA J e n U Pe l ay anan T an d a Daf t ar P e t e m ak an R ak y at







l e n t a n g P e l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i .


T a h u n 2 0 1 3 l e n t a n g P c l u n j u k



z u i z L c i i i a i i g r c j a y a n a n r e n z i n a n



2 , P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n g k o P e r m o h o n a n ;





d . M a t e r a i R p . 6 0 0 0 , - ;




g . F o i o c o p y S e r t i f i k a t / B u k t i

k e p e m i l i k a n l a n a h d a n a t a u S K P P l ;







j . B e r i t a A c a r a S o s i a l i s a s i w a r g a

s e k i l a r d i k e t a h u i K e t u a R T , R W d a n


k - S u r a t P e m y a t a a n / P e r s e t u j u a n

-J9 -



K e t u a R T . R W d a n K a d e s / L u r a h

a e t e m p a l ;

L D e n a h l o k a s i t e m p a t u s a h a ;

m . F o t o c o p y


n . R e k o m e n d a s i d a r i i n s l a n s i t e k n i s

t e r k a i t ;


p r o s e d u r





m a u p u n W e b r c s m i D P M P T S P .







3 . P r o s e s :

• p e m b a h a s a n / k a j i a n d a l a m

m e n m d a k J a n j u t i p e r m o h o n a n

t e r s e b u t .

* M e l a k u k a n p e m e r i k s a a n

l o k a s i -







b e n a r o l e h v e r i r i k a t o r .

5 - Bi av a/ t a r i f T R p , 0 . -


7 , S a r a n a . p r a s a r a n a

d a n / a t a u f a s L L L t a s




8 . K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 . S L

9 . P e n g a w a s a n i n t e m a l R a p a t s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i




m a s u k a n





p e n g a d u a n .






I L J u m l a h p e i a k s a n a 6 o r a n g e

1 2 . J a m i n a n p e l a v a n a n S O P , G r a t i s



N o m o r a n t r i a n d a n r u a n g t u n ^ ; u b e r

a c . t v , M e j a h e l p d e s k . CCT V

-10-

N O zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAK O M P O N E N U R A I A N


p e i a k s a n a

I K M u a p 5 b u l a n .

2 5 . J e n i s P c l ay anan T DUP Peny e lenggaraan K e g i at an Hi buran dan

R e k re aai .



B o y d a l i N o m o r 1 3 T a h u n 2 0 1 1

f ^ n t ^ ^ f i f f R ^ t r i h i J ^ i P p H z i n a n T p r t p n f u

• P e r a t u r a n D a e r a h K a b u p a l e n




B o y o l a l i ,

• P e r a i u r a n B u p a t i B o y o l a U N o m o r 1 0




2 0 1 2 l e n l a n g P e l a y a n a n P e r i z i n a n



2. P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n g k o P c r m o h o n a n i




C - F o t o c o p y N P W P ;

d ' M a t e r a i R p . 6 0 0 0 , -



f- F o t o c o p y 1 M B ;

g , F o i o c o p y S e r t i f i k a t / B u k t i


a . F o t o c o p y s a h A k t e




h , N e r a c a p e r u s a h a a n . s u s u n a n


i , F o t o c o p y


j , B e r i t a A c a r a S o s i a l i s a s i w a r g a

s e k i t a r d i k e t a h u i K e t u a R T , R W d a n


k . S u r a l P e m y a t a a n / P e r s e t u j u a n



s e t e m p a t ;

1. D e n a h l o k a s i t e m p a t u s a h a ;

m - S u r a l P e m y a t a a n k e s c d i a a n

m e l a k s a n a k a n k e t e n t u a n t e k n i s ,

m e n j a g a n o r m a a u a i l a , a g a m a s e s u a i

k e t e n t u a n p e r u n d a n g - u n d a n g a n

- I I -


y a n g b e r l a k u ;

n . R e k o m e n d a s i d a n I n s t a n s i T e k n i s

t e r k a i t ;

3 . S i s t e m . m e k a n i s m e . d a n

p r o s e d u r

a . P e m o h o n d a p a t m e n g a m b i l /





b . S e t e l a h b l a n g k o d i i s i d a n p e m y a t a a n






c. P r o s e s p e m b a h a s a n / k a j i a n d a l a m


t e r s e b u t .

d . S e l e s a i p r o s e s i j i n d a p a t d i a m b i l




3 ( T i g a ) h a r i kerja dari b e r k a s



5 . B i a y a / t a r i f f R p . 0 . -


7 . S a r a n a . p r a s a r a n a





8 . K o m p e t e n s i p e i a k s a n a D i k l a t P T S P . S M A / D 3 , S I .

9 . P e n g a w a s a n i n t e r n a ] R a p a t s t a f s e t i a p b u l a n . l a p o r a n m e l a l u i




m a s u k a n





p e n g a d u a n .






I L J u m l a h p e i a k s a n a 6 o r a n g .




N o m o r a n t r i a n d a n r u a n g t u n ^ u b e r

a c . t v . M e j a h e l p d e s k . C C T V


p e i a k s a n a


2 6 . J e n i s Pe laymnnn T DUP Pe ngo lahan Day a T ar i k Wi sat a,


1 , D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n



-4 2 -

N O K O M P O N E N U R A T A N



l e n l a n g P e l a y a n a n P e n z i n a n d a n N o n


B o y o l a l i ,







K a b u p a t e n B o y o l a l i ywtronmjfZWVMKJFA

2 . E * e r s a y a r a t a n P e l a y a n a n a . U n d a n g - u n d e n g a n y a n g b e r l a k u ;

b . R e k o m e n d a s i d a r i I n s t a n s i T e k n i s

t e r k a i i . M e n g i s i B l a n g k o

P e r m o h o n a n ;

c . F o i o c o p y K T P P e m o h o n y a n g m a s i h


m e l a m p i r k a n F o i o c o p y P a s p o r

d . F o i o c o p y N P W P ;

e . M a i e r a i R p . 6 0 0 0 , - ;

f. P a s f o t o b e r w a m a s e t e n g a h b a d a n



h . F o t o c o p y S e r t i f i k a t / B u k t i

k e p e m i l i k a n l a n a h d a n a t a u S K P P T ;

b . F o t o c o p y s a h A k l c






j . F o t o c o p y


A L A L I N ;

k . B e r i t a A c a r a S o s i a l i s a s i w a r g a



1. S u r a l P e m y a t a a n / P e r s e t u j u a n



a e t e m p a t ;

m . D e n a h l o k a s i t e m p a t u s a h a ;

n . S u r a t P e m y a t a a n k e s c d i a a n



k e t e n t u a n p e r u n d a n g


p r o s e d u r





m a u p u n W e b r e s m i D P M F T S P ,




N O K O M P O N E N U R A I A N zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA



p e n d a f t a r a n . ywtronmjfZWVMKJFA

% y . m i a C a p c i i j u a j m s a T ] / K a j j a i i u a i a m

m c m n d a k l a n j u t L p e r m o h o n a n

t e r s e b u t .

^. O C JC S H J p j U S LyvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA 9 JJIIJ U n p a L U I n I I I OIL

n a d a k i k p l r v m r n m b i l a n

U c i V J c lzywvutsrponmlkjihgfedcbaTSRPKJGA K L / L I • l e m J i f J J A I 11

4 . Jangka wakt u

p r n y e l e s a i a n

3 ( T i f i ^ l k e r j a d a r i be rkas p e r m o h o n a n d i t e r i m a t c n g k a p d a n

K p n a r o l e h v e r i f l k f l t o r

5 H i n v n / t n r i f f R D 0 -

6 . Produk p e l a v a n a n S K

O U TB U I t l , p i d n d l U l c l


M f i n k i i T ^ i e o T T i m i r ^ r P r i n t e r

I n i e m c i / A p l i k a s i s i s t e m / W e b / E m a i l ,

s m s s e r v i c e , g p s . A T K d a n m o b i l . P

8 . K o m p e t e n s i p e i a k s a n a D i k l a t PT SP, S M A / D 3 . S I .

9 . P e n g a w a s a n L n t e m a i R a p a t s t a f s e t i a p b u l a n , laporan m e l a l u i




m a s u k a n

* P e n g a d u a n d a t a n g k e D P M P T S P d i

p e r s i l a h k a n m a s u k k c r u a n g K h u s u s



L n . 1 1 K t l U l i a 1 1 '

* r C E I g A U U a l l ( i i i p i l l I J l C J a l U I H O [ U K

^ a m T i w e h HH n H e n ffa n f n r m a r a d J d J J , n d j p U A l 1 a J 1 1 3 U t J I K A L 1 i U i 1 U A L


D P M P T S P d a n a k a n d i b a l a s d e n a a n M M E 1* J 4 1 A M m V E x - E E 1 E-E # W E J i \ M i x^xA±E4 v v E 1 1 T 1 4

s o l u s i a d u a n . 11 a a ¥

J um l ah o e laksana 6 o r a n g .

1 2 . J am i nan p e l a v a n a n S O P . G r a t i s




a c . t v , M c i a h e l p d e s k , C C T V

1 4 . E v a l u a s i k i n e i j a

p e i a k s a n a


2 7 . J e n U PeLayaiuin T DUP Pcay edl&an Ako m o dasi .





• p e r a t u r a n D a e r a h K a b u p a l e n




B o y o l a l i ,

• p e r a i u r a n B u p a l i B o y o l a l i N o m o r 1 0




2 0 1 2 t e n l a n g P e l a y a n a n P e n z m a n



-44-


2 . P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n g k o P e r m o h o n a n ;





d . M a t e r a i R p . 6 0 0 0 , - ;

e. P a s f o t o b e r w a r n a s e i e n g a h b a d a n




k e p e m i l i k a n t a n a h d a n a l a u S K P P J ;

5 . F o i o c o p y s a h A k t e




h . N e r a c a p e r u s a h a a n . s u s u n a n


i . F o i o c o p y


A L A L I N ;

j . B e r i t a A c a r a S o s i a l i s a s i w a i ^



k . S u r a t P e m y a t a a n / P e r s e t u j u a n



s e t e m p a t ;

I . D e n a h l o k a s i t e m p a t u s a h a ;

m . S u r a l P e m y a t a a n k e s e d i a a n



k e i e n l u a n p e r u n d a n g - u n d a n g a n

y a n g b e r l a k u ; zywvutsrponmlkjihgfedcbaTSRPKJGA

n. R e k o m e n d a s i d a r i I n s t a n s i T e k n i s

t e r k a i t .

3 . S i s t e m . m e k a n i s m e , d a n

p r o s e d u r

1 , P e m o h o n d a p a t m e n g a m b i l /


k e b u t u h a n y a n g j u g a l e l a h









3 , P r o s e s p e m b a h a s a n / k a j i a n d a l a m zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBAEywtronmjfZWVMKJFA ' M


t e r s e b u t .





3 ( T i g a ) h a r i k e r j a d a r i b e r k a s



- 4 5 -

N O 1 K O M P O N E N U R A I A N

5 . B i a v a / t a r i i r 1 R p .zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA 0 , -

6 . Produk p e l a v a n a n S K zywvutsrponmlkjihgfedcbaTSRPKJGA

1. S a r a n a . p r a s a r a n a


M e j a . k u r s i , c o m p u t e r . P r i n t e r ,



8 . K o m p e t e n s i p e i a k s a n a D i k l a t P T S P . S M A / D 3 . S I .




D c n a a d u a n , s a r a n . d a n

m a s u k a n

• P e n g a d u a n d a t a n g k r D P M P T S P d i

n e r s i l a h k a n m a s u k k e r u u n c K h u s u s • _ # X J LywtronmjfZWVMKJFA mf L I •_• • • J X I _ X JMJH M L J I l — L mJ • X • X ^ _ I •_• l — L • • XL • X I J % _ L mJ


s o l u s i o l e h o e t u s a s n e n e n m a

p e n g a d u a n .

• P e n g a d u a n d a o a l m e l a l u i k o t a k




s o l u s i a d u a n . n . J u m l a h p e i a k s a n a t o r a n g .

12q J a m i n a n p e l a v a n a n SOP , G r a t i s


k e a e t a m a t a n p e l a y a n a n

N n m o r a n t r i a n d a n r u a n g t u n g g u b e r

a c , l v , M e j a h e l p d e s k . C C T V

14. E v a l u a s i k i n e g a

p e i a k s a n a


2 8 . J e n U P c Uy an an T DUP J a u T r un p o r t an i Wi s a U.

N O K O M P O N E N

I . D a s a r H u k u m •

*

«

2 . P e r s a y a r a t a n P c l a y a n a n a .

b .

c .

d .

c .

r.

URAIAN



I c n l a n g R e t r i b u s i P e r i z i n a n T e r t e n l u .



t e n t a n g P e l a y a n a n P e n z i n a n d a n N o n


B o y o l a l i ,

P e r a t u r a n B u p a l i B o y o l a l i N o m o r 1 0




2 0 ] 2 t e n t a n g P e l a y a n a n P e r i z i n a n



M e n g i s i B l a n g k o P e r m o h o n a n ;

F c i t ( x : o p y K T P P e m o h o n y a n g m a s i h



F o i o c o p y N P W P ;

M a t e r a i R p . 6 0 0 0 . - ;

P a s f o t o b e r w a m a s e t e n g a h b a d a n

u k u r a n 4 X 6 2 ( d u a } l e m b a r ;

F o t o c o p y I M B ;

F o i o c o p y S e r t i f i k a l / B u k t i



5 . F o t o c o p y s a h A k t e






i . F o t o c o p v


A L A L I N ;

j , D e n a h l o k a s i t e m p a t u s a h a ;

k . S u r a t P e m y a t a a n k e s e d i a a n

m e l a k s a n a k a n k e t e n l u a n t e k n i s ,




o . R e k o m e n d a s i d a r i I n s l a n s i T e k n i s

t e r k a i t ;


p r o s e d u r

1 . P e m o h o n d a p a l m e n g a m b i l /













t e r s e b u L





3 f T i g a ) h a r i k e r j a d a r i b e r k a s



5 . B i a y a / t a r i f T R p . 0 , -

6 . P r o d u k p e l a y a n a n S K

7 . S a r a n a . p r a s a r a n a










m a s u k a n


p e r s i l a h k a n m a s u k k e n j a n g K h u s u s

p e n g a d u a n d a n d i f a s i l i t a s i d e n g a n


p e n g a d u a n .


s a r a n . w e b , d a n s m s d e n g a n f o r m a t


D P M P T S P d a n a k a n d i b a l a s d e n g a n zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

-47-

NO K OMPONEN UEtAIAN zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA


n . J u m l a h p e i a k s a n a 4 o r a n g .

12 . J a m l n n n p e l a v a n a n SOP. G r a t i s

13 . J a m i n a n k e a m a n a n d a n





p e i a k s a n a

[KM t i a p 6 b u l a n .

2 9 . J e n U Pe l ay anan T DUP J a s a Makanan dan Mi num an.

NO K OMPONEN URAIAN

1. D a s a r H u i c u m • P e r a t u r a n D a e r a n K a b u p a t e n



» P e r a t u r a n D a e r a h K a b u p a t e n


t e n l a n g P e l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,

• P e r a i u r a n B u p a t i B o y o l a l i N o m o r 10



K a b u p a t e n B o y o l a i i N o m o r 4 T a h u n



K a b u p a l e n B o y o l a l i

2 . P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n g k o P e r m o h o n a i i ;





d - M a i e r a i R p . 6 0 0 0 , - ;



f. F o t o c o p y [ M B ;


k e p e m i l i k a n l a n a h d a n a l a u S K P P T ;


P e n d i n a n / P e r u b a b a n n y a y a n g m a s i h





i . F o t o c o p y


A L A L I N ;

j . B e r i t a A c a r a S o s i a l i s a s i w a r g a

s e k i t a r d i k e t a h u i K e t u azywvutsrponmlkjihgfedcbaTSRPKJGA RT. R W d a n


k - S u r a t P e m y a t a a n / F * e r s e t u j u a n

L i n g k u n g a n s e k i l a r y a n g d i k e t a h u i


s e t e m p a t ;

I . D e n a h l o k a s i t e m p a t u s a h a ;

-48 -


m . S u r a t P e m y a t a a n k e s e d i a a n





n . R e k o m e n d a s i d a r i I n s t a n s i T e k n i s

t e r k a i t .


p r o s e d u r

1, P e m o h o n d a p a t m e n g a m b i l /













t e r s e b u t ,

4 . S e l c s a i p r o s e s i j i n d a p a l d i a m b i l


J a n g k a w a k t u





5 . B i a y a / t a r i f f R p . 0 . -




M e j a . k u r s i . c o m p u t e r . P r i n t e r ,

I n l e m e l / A p l i k a s i s i s l e m / W e b / E m a i l ,



9, P e r ^ w a s a n i n t e m a l R a p a t s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i

a p l i k a s i s i s t e m -



m a s u k a n


p e r s i l a h k a n m a s u k k e m a n g K h u s u s



p e n g a d u a n .


s a r a n . w e b , d a n s m s d e n g a n f o r m a l




1 1 . J u m l a h p e i a k s a n a 6 o r a n e .





a c . t v , M e p a h e l p d e s k , C C T V


p e i a k s a n a

IKM t i a p 6 b u l a n .

-49 -

3 0zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA J e n i s P c Uy a n s n T DUP J a u P c r j s l snan W i u t a .

NO K O M P O N E N U R A E A N

1. Dasar H u k u m

E V r s a y a r a t a i i P e l a v c i n a n

• P e r a t u r a n D a e r a h K a b u p a l e n B o y o l a l i

N o m o r 1 3 T a h u n 2 0 1 1 l e n t a n g

R e l n b u s i E ^ r i z i n a n T e r t e n l u ,

• E ^ r a t u r a n D a e r a h K a b u p a l e n B o y o l a l i




B o y o l a l i ,


T a h u n 2 0 1 3 t e n l a n g P c l u n j u k



2 0 1 2 l e n t a n g P e l a y a n a n F ^ r i z i n a n d a n


B o y o l a l i — — —

2.

Dasar H u k u m

E V r s a y a r a t a i i P e l a v c i n a n a M e n g i s i B l a n c o P e r m o h o n a n :


b e r l a k uzywvutsrponmlkjihgfedcbaTSRPKJGA ijika s u a m i / i s l r i W N A )



d . M a i c r a i R p . 6 0 0 0 , - ;

c. P a s f o t o b e r w a m a s e t e n g a h b a d a n


r F o t o c o p y [ M B ;

g. F o t o c o p y S e r t i f i k a l / B u k l i k e p e m i l i k a n

l a n a h d a n a l a u S K P P T ;

7. F o t o c o p y s a h A k t e



b u k u m ;



i . F o i o c o p y

A M D A L / U K L / U P L / D P P L / S P P L / A N D A

L A L I N ;

j . D e n a h l o k a s i t e m p a t u s a h a :

k . S u r a l P e m y a t a a n k e s e d i a a n


m e n j a g a n o r m a s u s i l a . a g a m a s e s u a i

k e t e n t u a n p e r u n d a n g - u n d a n g a n y a n g

b e r l a k u ;

L R e k o m e n d a s i d a n E n s t a n s i T e k n i s

t e r k a i t ;

3 , S i s l e m , m e k a n i s m e , d e n

p r o s e d u r

1 , P e m o h o n d a p a t m e n g a m b i l /




m a u p u n W e b r e s m i D P M F T S P .





- w -

N O zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAK O M P O N E N U R A I A N



3 . P r o s e s p e m b a h a s a n / k a j i a n d a l a m ywtronmjfZWVMKJFAV ' M


t e r s e b u t .





3 { T i g a ) h a r i k e i j a d a n b e r k a s



5 . B i a v a / t a r U T R D. 0 , -

6 . P r o d u k p e l a y a n a n S K zywvutsrponmlkjihgfedcbaTSRPKJGA


d a n / a i a u f a s i l i L a s



sm s s e r v i c e , g p s , A T K d a n m o b i l .

K o m p e t e n s i p e i a k s a n a D i k l a t P T S P . S M A / D 3 . S K

9 . P e n g a w a s a n i n l e r n a l R a p a t s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i




m a s u k a n


p e r s i l a h k a n m a s u k k e m a n g K h u s u s



p e n g a d u a n -

* P e n g a d u a n d a p a t m e l a l u i k o t a k





1 1 . l i j t i i l a h L K h i k s a n a 4 o r a n g -


K T J a m i n a n k e a m a n a n d a n



a c l v . M e i a h e l p d e s k . C C T V


p e i a k s a n a


3 1 . J c Di s P e l ay anan T DUP K o naul t aai Part wlaat a.


K Dasar H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n

B o y o i a l i N o m o r 1 3 T a h u n 2 0 1 1






B o y o l a l i ,








2 . P e r s a v a r a t a n P e l a v a n a n a- M e n g i s i B l a n g k o P e r m o h o n a n ;

• 5 1 -






d . M a t e r a i R p . 6 0 0 0 . - ;




g . F o t o c o p y S e r t i f i k a l / B u k t i

k e p e m i l i k a n t a n a h d a n a i a u S K P P T ;





h . N e r a c a p e r u s a h a a n . s u s u n a n

p e n g u r u s d a n p e m e g a n g s a h a m ; zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

L. F o t o c o p y


j , D e n a h l o k a s i t e m p a t u s a h a ;

k , S u r a t P e m y a t a a n k e s e d i a a n

m e l a k s a n a k a n k e t e n t u a n t c k n i s ,

m e n j a g a n o r m a s u s i l a . a g a m a s e s u a i



1, R e k o m e n d a s i d a r i I n s t a n s i T e k n i s

t e r k a i t ;

3 . S i s l e m . m e k a n i s m e , d a n

p r o s e d u r

1 . P e m o h o n d a p a l m e n g a m b i l /





2 . S e t e l a h b l a n g k o d i i a i d a n p e m y a t a a n








t e r s e b u t . zywvutsrponmlkjihgfedcbaTSRPKJGA

4. S d t - s a i p r o s e s i j i n d a p a l d i a m b i l




3 f T i g a ) h a r i k e i j a d a r i b e r k a s



5 . B i a v a / t a r i f T M ± 1

R p . 0 , -ywtronmjfZWVMKJFAM £










-52-

N O K O M P f J N E N U R A I A N

1 0 P e n a n g a n a n


m a s u k a n



P e n g a d u a n d a n d i f a s L l l l a s i d e n g a n

s o l u s i o l e h p e t u g a s p e n e n m a XVUTOLKJIHFDCBT VzywvutsrponmlkjihgfedcbaTSRPKJGA t\ on dyvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA 1 1 n

* c e n g A L JzyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA u a n u n p n i T i i c i a j u i H U L O K

s a r a n w e h H a n s m s rienffan f o r m A l

t e r t e n l u k e n o m o r o e n c a d u a n



1 1 . J u m l a h D c l a k s a n a 4 o r a n g -


1 3 . J a m i n a n k e a m a n a n d a n N o m o r a n t r i a n d a n r u a n g tunggu ber

k e s e l a m a t a n p e l a y a n a n a c t v . M c i a h e l p d e s k . CCT V


p e i a k s a n a


3 2 . J c B i s Pe lay ai uui T DUP I n f o m ui s l P a r i w t ut a .

NO K n M E * O N E N U R A I A N



R e t r i b u s i P e n z i n a n T e r t e n t u .



P c l a y a n a n P e r i z i n a n d a n N o n


B o y o l a l i ,

• P e r a t u r a n B u p a t i B o y o l a i i N o m o r 1 0




2 0 1 2 t e n t a n g P e l a y a n a n P e r i z i n a n d a n

n o n P e r i z i n a n T e r p a d u K a b u p a l e n

B o y o l a i i

2. Pe rsay arat an Pe lay anan a . M e n g i s i B l a n g k o P e r m o h o n a n ;




c - F o t o c o p y N P W P ,

d . M a i c r a i R p . 6 0 0 0 , - :

c . P a s f o t o b e r w a m a s e i e n g a h b a d a n



g . F o t o c o p y S e r t i f i k a t / B u k l i k e p c m i l i k a n

l a n a h d a n a t a u S K P P T ;




h u k u m ;



i . F o t o c o p v


J . D e n a h l o k a s i t e m p a t u s a h a ;

-53 -


k . S u r a l P e m y a t a a n k e s e d i a a n



k e t e n l u a n p c r u n d a n g - u n d a n g a n y a n g

b e r l a k u ;


t e r k a i t ; zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA


p r o s e d u r










s e l a n j u m y a d i b e r i t a n d a b u k t i

p e n d a f t a r a n ,



t e r s e b u t .








5 . B i a y a / t a r i f f R p . 0 , -

6 . P r o d u k p e l a y a n a n 5 K




I n t e m e t / A p l i k a s i s i s l e m / W e b / E m a i l ,







m a s u k a n





p e n g a d u a n .

* P e n g a d u a n d a p a l m e l a l u i k o t a k





n . J u m l a h p e i a k s a n a 4 o r a n g .





a c . t v . M c i a h e l p d e s k . CCT V


p e i a k s a n a


3 3 . J e n i s P e l s y s a s n T DUP J s s s F n un n w l ss t s ,



-54-


B o y o l a l i N o m o r ! 3 T a h u n 2 0 1 1

t e n l a n g R c l r i b u s L P e r i z i n a n T e r t e n l u .

• P e r a t u r a n D a e r a h K a b u p a l e n


t e n t a n g P e l a y a n a n P e n z i n a n d a n N o n


B o y o i a l i ,


T a h u n 2 0 1 3 l e n l a n t r P e f i i n i i i l c





K a b u p a t e n B o v o l a l i

2 . P e r s a y a r a t a n Pe layanan a. M e n g i s i B l a n g k o P e r m o h o n a n ;





d . M a t e r a i R p . 6 O O 0 . - ;

c. P a s f o l o b e r w a m a s e t e n g a h b a d a n



g . F o t o c o p y S e r t i f i k a l / B u k t i

k e p c m i l i k a n l a n a h d a n a t a u S K P P T ;







i . F o t o c o p y


J . D e n a h l o k a s i t e m p a t u s a h a ;

k . S u r a t P r m y a l a a n k e s e d i a a n


m e n i a s a n o r m a s u s i l a a s a m a s e s u a i




I c r k a i t ;

3. S i s t e m . m e k a n i s m e , d a n

p r o s e d u r





m a u p u n W e b r c s m i D P M P T S P . ywtronmjfZWVMKJFA


l e n g k a p o l e h p c m o h * > n d a p a t

d i k c m b a l i k a n u n l u k d i d a f t a r






-55-


t e r s e b u t .





3 ( T i g a l h a r i k e r j a d a r i b e r k a s



5 . B i a y a / t a r i f f R p . 0 . -

6 , P r o d u k p e l a y a n a n S K zywvutsrponmlkjihgfedcbaTSRPKJGA



M e j a , k u r s i , c o m p u t e r , P r i n t e r .

I n l e m e t / A p l i k a s L s i s t e m / W e b / E m a i l ,


K o m p e t e n s i p e i a k s a n a D i k l a tzyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA FT SP . S M A / D 3 , S L

9 . P e n g a w a s a n i n t e m a l R a p a t s t a f s e t i a p b u l a n . l a p o r a n m e l a l u i




m a s u k a n





p e n g a d u a n .


s a r a n . w e b . d a n s m s d e n g a n f o r m a t









a c . i v , M e j a h e l p d e s k , C C T V


p e i a k s a n a


3 4 . J e n i s P e Uy anan T DUP W i u U T irt f t .



N o m o r t 3 T a h u n 2 0 1 1 l e n t a n g






B o y o l a l i .







B o y o l a l i

2 . P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n g k o P e r m o h o n a n ;





-56-


d , M a i c r a i R p . 6 0 0 0 , - ;

c- P a s f o t o b e r w a m a s e t e n g a h b a d a n



g . F o i o c o p y S e r t i f i k a i / B u k t i k e p e m i l i k a n

l a n a h d a n a t a u S K P P T ;




h u k u m ;

i . N e r a c a p e r u s a h a a n . s u s u n a n ,


j . F o i o c o p y


L A L J N ;

k . B e r i t a A c a r a S o s i a l i s a s i w a r g a s e k i t a r

d i k e t a h u i K e l u a R T , R W d a n


1, S u r a t P e m y a t a a n / P e r s e t u j u a n


K e l u a R T , R W d a n K a d c s / L u r a h

a e t e m p a l ;


n . S u r a l P e m y a t a a n k e s e d i a a n

m e l a k s a n a k a n k e t e n t u a n l e k m s ,

m e m a g a n o r m a s u s i l a . a g a m a s e s u a i


b e r l a k u ;

0 . R e k o m e n d a s i d a r i I n s t a n s i T e k n i s

l e r k a i t .

S i s t e m , m e k a n i s m e . d a n

p r o s e d u r

] , P e m o h o n d a p a t m e n g a m b i l /













t e r s e b u t .

4 , S e l c s a i p r o s e s i j i n d a p a t d i a m b i l






b e n a r f i l e h v e r i f i k a t o r .

5 - f B i a v a / t a r i f f R D. [).-


7 . S a r E i n a . p r a s a r a n a M e j a , k u r s i . c o m p u t e r . P r i n t e r ,

d a n / i i i i i u k i s i l i i a s I n t e m e t / A p l i k a s i s i s t e m / W e b / E m a i l ,

•57-


s m s s e r v i c e , g p s , A T K d a n m o b i L

8 , K o m p e t e n s i p e i a k s a n a D i k l a i F T S P , S M A / D 3 , S I . ywtronmjfZWVMKJFA





m a s u k a n




s o l u s i o l e h p e t u g a s p e n e r i m a yvutrponmlkjifedcaZXWVUTSOMLKJIHEDCAT i e n p a d vXVUTOLKJIHFDCB J a n P

• PI * T l 1 1 1 1 n T i / i [ t i ~ i [ t 1 T n ^ l a l i i i l / n t a l / zywvutsrponmlkjihgfedcbaTSRPKJGAm r c J J g n u U d J J u a pa i 1 1 I d d J Kl l H U L O H

s a r a n w e b d a n s m s d e n p n n f o r m n i ^ L V L LzyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA 4 p S p K4 4A J l h ? 4 L J i J S.±S 1 J J i L J L 1 4 C L A



s o l u s i a d u a n . n * • •

J u m l a l i n e l a k S a n a if orane X X XX I C H L I _



k e s ( - l ; i m a t a n p e l a v a n a n


a c . t v . M e j a h e l p d e s k , CCT V


p e i a k s a n a


3 5 . J e n i a PeUy mnan T DUP Spa.


1 , D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i







B o y o l a l i ,

• P e r a t u r a n B u p a i i B o y o l a l i N o m o r 1 0




2 0 1 2 t e n l a n g P e l a y a n a n P e n z i n a n d a n


B o v o l a l i

2. P e r s a y a r a t a n Pe layanan a . M e n g i s i B l a n g k o P e r m o h o n a n ;


b e r l a k u ( j i k a s u a m i / i s t n W N A l



d . M a t e r a i R p . 6 O 0 0 , - ;


u k u r a n 4 X b 2 ( d u a ) l e m b a r ;


g . F o i o c o p y S e r t i f i k a i / B u k t i k e p e m i l i k a n

l a n a h d a n a l a u S K P P T ;



1 b e r l a k u b a g i p e m o h o n v a n g b e r b a d a n

• SB-

NO zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAK O M P O N E N URAIAN

h u k u m :



j , F o t o c o p y


L A L I N ;

k . B e r i t a A c a r a S o s i a l i s a s i w a r g a s e k i t a r

d i k e t a h u i K e t u a R T , R W d a n


1. S u r a l P e m y a t a a n / P e r s e t u j u a n



s e t e m p a t ;






b e r l a k u ;

o . R e k o m e n d a s i d a r i I n s t a n s i T e k n i s

t e r k a i t .

3, S i s t e m , m e k a n i s m e , d a n

p r o s e d u r

1- P e m o h o n d a p a t m e n g a m b i l /





2 . S e t c l u h b l a n g k o d i i s i d a n p e m y a t a a n






3 . P r o s e s p e m b a h a s a n / k a j i a n d a l a m 1ywtronmjfZWVMKJFA * M


t e r s e b u t



4, J a n g k a w a k t u


3 ( T i g a ) h u r i k e r j a d a r i b e r k a s



5 . B i a y a / t a r i f f Z £

Rp, 0 ,-

6 , P r o d u k p c l a y a n a n S K zywvutsrponmlkjihgfedcbaTSRPKJGA

^ 1 . S a r a n a , p r a s a r a n a



I n t e r n e t / A p h k a s i s i s t e m / W e b / E m a i l ,

s m s s e r v i c e , g p a , A T K d a n m o b i l .

8. K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 . S I .

9 . P e n g a w a s a n i n t e r n a l R a p a l s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i



p e n g a d u a n , s j t r a n , d a n

m a s u k a n




so lusi o leh p e t u g a s p e n e r i m a

- 59 -


t ! > e n c a d L i A n L 1 ^ k ywtronmjfZWVMKJFAK M x J U L L n

• P e n c a d u a n d a n a t m e l a l u i k n i a k ^ • X - L L ^ ^ x S x * V 1 4 ^ • L V * k 4 k x x 4 k B 1 1 X i x x X x J J JVL_/ L_Cmx

s a r a n w e b d a n s m s d e n c a n f o n n H t • V f r x I T - X •-• • ± v l ± ± X X X V 1 L S x L 4 J \ J L J L I C a K


D P M P T S P d a n a k a n d i b a l a a d e n g a n


1 1 J u m l a h D c l a k s a n a P 4 o rans

1 2 . • J a m i n a n p < ' l a s a n a n SOP, G r a t i s

1 3 . l a m i n a n k t i i i i L a i i a n d a n

k e s e l a m a i a n p e l a y a n a n

Nomor a n t r i a n d a n ruang t u n g g u b e r

ac.t v , M e j a h e l p d e s k , C C T V

1 4 . E v o l u a s i k i n e r j a

p e i a k s a n a

I K M t i a p 6 b u i a n .

3 6 . J e n t B P e Uy an an T DUP Kmwasan W Ua U.

k ' < J M P i ) N R N 1I R A 1 A N V i Y j \ j n i i

L D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a l e n B o y o l a l i





P e l a y a n a n P e n z i n a n d a n N o n P e r i z i n a n

T e r p a d u K a b u p a l e n B o y o l a l i .

• P e r a t u r a n B u p a i i B o y o l a l i N o m o r 1 0





n o n P e n z i n a n T e r p a d u K a b u p a t e n

B o v o l a l i —

P e r s a y a r a t a n P e l a y a n a n a . M e n g i s i B l a n g k o P e r m o h o n a n ;


b e r l a k u 0 ' '*^ s u a m i / i a l r i W N A )



d. M a t e r a i R p . 6 0 0 0 . - ;

c. P a s f o t o b e r w a m a s e i e n g a h b a d a n


f. F o i o c o p y I M B ; zywvutsrponmlkjihgfedcbaTSRPKJGA

g. F o t o c o p y S e r t i f i k a t / B u k t i

k e p e m i l i k a n t a n a h d a n a l a u S K P P T ;

h . F o t o c o p y s a h A k l c

P e n d i r i a n / P e r u b a h a n n y a y a n g m a a i h



i . N e r a c a p e r u s a h a a n . s u s u n a n


j , F o t o c o p v


A L A L I N ;

k . B e r i i a A c a r a S o s i a l i s a s i w a r g a s e k i t a i r

d i k e t a h u i K e t u a R T , R W d a n


1, S u r a l P e m y a t a a n / P c r s e i u l u a n




s e t e m p a t ;


n . S u r a t P e m y a t a a n k e s e d i a a n yvutrponmlkjifedcaZXWVUTSOMLKJIHEDCAI L I L l u r v Z H l J J A > U U L n t T L d l L U r X J i [ d \ J I J S .




o . R e k o m e n d a s i d a r i I n s l a n s i T e k n i s

I c r k a i l .


p r o s e d u r



k e b u t u h a n y a n gzywvutsrponmlkjihgfedcbaTSRPKJGA juga l e l a h



2. S c i e l a h b l a n g k o d i i s i d a n p e m y a t a a n






3 P r o s e s o e m b a h a s a n / k a i i a n d a l a m \ M 1 * w ' M ^ - F ^ 1 * J • T ' V I 4 ¥ x x • -•x B * • J ^ x x " J f X X X 4 A M x x 1 x 4 4 W 4

m e n i n d a k l a n j u t i p e r m o h o n a n .

t e r s e b u t .

4 S e l e s a i o r o s e s i i i n d u o a i d i a m b i l • ^ M V - 4 \r ^ ^ x x 4 v x V 4 t 4 4 4 x V x 4 k ^ x 4 x x 1 i 4 x 4 i * v • •

p a d a l o k e l p e n g a m b i l a n .

4 . J a n g k a wakt u





5 . B u i v a / t a r i f f R p . 0 , -

6 . P r i n i u k p e l a y a n a n S K




T n t e m e i / A p l i k a s i s i s t e m / W e b / E m a i l ,


8 . Kompetensi pe i aksana D i k l a t F T S P , S M A / D 3 ^ S L

9 , P e n g a w a s a n i n t e m a l R a p a t s l a f s e t i a p b u l a n , l a p o r a n m e l a l u i




m a s u k a n





D C n c a d u a n ^ ^ X ^ L L4 _X X _ B X_HX_B b i n

• P e n c a d u a n d a o a t m e l a l u j k o t a k


t e r t e n l u k c n o m t i r p e n g a d u a n


s o l u s i a d u a n -I L J u m l a h p e i a k s a n a 6 o r a n g .

1 2 . J a m i n a n o c l a v a n a n S O P . Grat i s




a c , l v , M e i a h e l p d e s k . C C T V

1 4 . E v a l u a s i k i n e r i a I K M t i a p 6 b u l a n .

-61-

N O zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA1

K O M P O N E N U R A I A N

p e i a k s a n a

3 7 . J e n U P e Uy an an T DUP Pe nyelenggaramn P e r t e m uan cUn

P am e ran .

NO K O M [ * l ) N E N U R A I A N yvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA] . D a s a r H u k u m • P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i

N o m o r 1 3 T a h u n 2 0 1 1 t c m a n g




P c l a y a n a n P e r i z i n a n d a n N o n P e r i z i n a n

T e r p a d u K a b u p a t e n B o y o i a l i ,

• P e r a i u r a n B u p a l i B o y o l a l i N o m o r 1 0




2 0 1 2 l e n l a n g P e l a y a n a n P e n z i n a n d a n


B o v o l a l i

2 . P e r s a y a r a t a n P e l a y a n a n zywvutsrponmlkjihgfedcbaTSRPKJGAA. M e n g i s i B l a n g k o P e r m o h o n a n ;


b e r l a k u ijika s u a m i / i s t r i W N A )



6. M a t e r a i R p . 6 0 0 0 , - ;

e . P a s f o l o b e r w a m a s e t e n g a h b a d a n

u k u r a n 4 X 6 2 ( d u a ) l e m b a r ; rr F o t o c o p y 1 M B ;

g , F o i o c o p y S e r t i f i k a t / B u k l i

k e p e m i l i k a n l a n a h d a n a t a u S K P P T ;





L. N e r a c a p e r u s a h a a n , s u s u n a n


j . F o i o c o p y


A L A L I N ;

k . B e r i i a A c a r a S o s i a l i s a s i w a r g a s e k i t a r

d i k e t a h u i K e l u a R T . R W d a n

K a d e s / L u r a h :

L S u r a l P e m y a t a a n / P e r s e t u j u a n

L i n g k u n g a n s e k i l a r y a n g d i k e t a h u i


s e t e m p a t ;

m , D e n a h l o k a s i t e m p a t u s a h a ;


m e l a k s a n a k a n k e t e n l u a n t e k n i s ,


k e t e n t u a n p c r u n d a n g - u n d a n g a n



t e r k a i t .

N O zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA» — —


3 - S i s t e m , m e k a n i s m e , d a n

p r o s e d u r

1. P e m o h o n d a p a l m e n g a m b i l /




m a u p u n W e b r e s m i D P M F i ' S P .





s e i a n j u t n y a d i b e r i l a n d a b u k l i



m c nyvutrponmlkjifedcaZXWVUTSOMLKJIHEDCA L n d a k l a n i u t i o e r m o h o n a n

t e r s e b u I .


p a d a l o k e l p e n g a m b i l a n .



3 ( T i g a } h a r i k e r j a d a r i b e r k a s



5 , B i a y a / t a r i f T R p . U , -

6. P r o d u k p c l a y a n a n SK zywvutsrponmlkjihgfedcbaTSRPKJGA



M e j a , k u r a i , c o m p u t e r , P r i n t e r , J F 1 F F

I n t c m e l / A p i i k a s i s i s t e m / W e b / E m a i l ,

s m s s e r v i c e , g p s , A T K d a n m o b i l . 8, K o m p e t e n s i p e i a k s a n a D i k l a t P T S P , S M A / D 3 , S l -

9 , P e n g a w a s a n i n t e r n a l R a p a t s t a f s e t i a p b u l a n , l a p o r a n m e l a l u i

a p l i k a s i s i s t e m -



m a s u k a n

• P e n g a d u a n d a i a n g k c D P M P T S P d i




p e n g a d u a n .

« P e n g a d u a n d a p a t m e l a l u i k o t a k


t e r t e n t u kc n o m o r p e n g a d u a n

D P M F I b P d a n a k a n d i b a l a s d e n g a n


1 1 J u m l a h p e i a k s a n a 6 o r a n g .

1 2 . l a m i n a T i i w l a y a n a n S0Pj_Grat i8




a c , t v , M e j a h e l p d e s k , C C T V


p e i a k s a n a

I K M t i a p b b u l a n .

3 8 . J e n i s P c l M y an u I x i n Me nd i r i kan Bangunan.

N O 1 K O M P O N E N U R A I A N

I . D a s a r H u k u m * P e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i

N o m o r 1 3 T a h u n 2 0 1 1 t e n l a n g


• p e r a t u r a n D a e r a h K a b u p a t e n B o y o l a l i


P e l a y a n a n P e n z i n a n d a n N o n P e r i z i n a n


T e r p a d u K a b u p a l e n B o y o l a l i ,

• P e r a t u r a n B u p a l i B o y o l a l i N o m o rzyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA 10




2 0 1 2 l e n l a n g P c l a y a n a n P e r i z i n a n d a n

n o n P e r i z i n a n T e r p a d u K a b u p a l e n

B o y o l a l i


b e r l a k u { j i k a s u a m i / i s t n W N A )


c . F o t o c o p y A k t e P c n d i n a n / A n g g a r a n

d a s a r a p a b i l a b e r b e n t u k b a d a n h u k u m ;

d . F o t o c o p y S e r t i l i k a t / B u k t i k e p e m i l i k a n

t a n a h d a n a l a u S K P P T ;

c, F o t o c o p y S P P T P B B t e r a k h i r d a n b u k t i

p c l u n a s a n n y a ;

f. F o i o c o p y

A M D A L / U K L / U P L / D P P L / S P P L / A N D A L

A U N ;

g . S u r a l K e t e r a n g a n d a n K e p a l a

D e s a / L u r a h b a h w a t a n a h t i d a k d a l a m

s e n g k c t a / m a s a l a h ;

h . B e r i t a a c a r a s o s i a l i s a s i b a g i b a n g u n a n

t empal usaha y a n g m e n i m b u l k a n

g a n g g u a n l u a s p a d a m a s y a r a k a t ;

i . S u r a l P e m y a t a a n / p e r s e l u j u a n

l i n g k u n g a n l e l a n g g a y a n g b c r d e k a t a n

l a n g s u n g d e n g a n l o k a s i y a n g a k a n

d i b a n g u n d i k e t a h u i K e p a l a

D e s a / L u r a h d a n C a r n a l s e t e m p a l b a g i

b a n g u n a n t e m p a t i b a d a h , b a n g u n a n

b e r l i n g k a t d a n b a n g u n a n t e m p a t

u s a h a ;

j . R e k o m e n d a s i d a n F K U B d a n K a n t o r

K e m e n i e n a n A g a m a K a b u p a l e n

B o y o l a l i b a g i 1 M B T e m p a t I b a d a h y a n g

b e r d i r i m u l a i t a h u n 2 0 0 6 d a n

s c l c l a h n y a ;

k . S u r a l k e t e r a n g a n d a r i

p e n d i r i / p e n g u r u s t e m p a l i b a d a h

t e n l a n g k r o n o l o g i a w a l b e r d i r i n y a

t e m p a t i b a d a h s e b e l u m t a h u n 2 0 0 6 ;

1. S u r a l p e m y a t a a n d a r i K e p a l a

D e s a / L u r a h d i k e t a h u i C a r n a l s e t e m p a t

b a h w a b e r d i r i n y a t e m p a l i b a d a h t i d a k

a k a n m e n i m b u l k a n p o l c n s i k o n f l i k ,

k h u s u s n y a b a g i t e m p a t i b a d a h y a n g

b e r d i r i s e b e l u m t a h u n 2 0 0 6 ;

m . G a m b a r T e k n i k B a n g u n a n ( r a n g k a p 3 ) ;

n . P c r h i i u n g a n s l r u k t u r k h u s u s

b a n g u n a n b e r l i n g k a t / b c t a n g p a n j a n g

( r a n g k a p 3 ) ; _

P e n w i y a r a l a n P c l a y a n a n a , M e n g i s i B l a n g k o P e r m o h o n a n

-64-

N O K O M P O N E N U R A I A N zyxwvutsrqponmlkjihgfedcbaYXWVUTSRQPONMLKJIHGFEDCBA

3, S i s l e m , m e k a r i L s m e , d a n

p r o s e d u r

1 - P e m o h o n d a p a t m e n g a m b i l




m a u p u n W e b r e s m i D P M F l ' S P -





s e i a n j u t n y a d i b e r i l a n d a b u k l i


3 . P r o s e s :

* p e m b a h a s a n / k a j i a n d a l a m


t e r s e b u t .

* M e l a k u k a n p e m e r i k s a a n l o k a s i

• P e n e t a p a n j u m l a h r e s t r i b u s i .

• p e m o h o n d a p a l m e m b a y a r

r e s m b u s i p a d a l o k e i p e m b a y a r .


p a d a l o k e t p e n g a m b i l a n . zywvutsrponmlkjihgfedcbaTSRPKJGA

A. J a n g k a w a k t u


7 ( l u j u h ) b a n k e r j a d a r i b e r k a s



5 . i i . L . 1 / t a r i f f a . R e t r i b u s i P e m b a n g u n a n G c d L o i L : H n i n i

L x I I j t l . O O x H S b g

b . R e t r i b u s i R e h a b i l i l a s i / R e n o v a s i

B a n g u n a n G e d u n g

L X I t X T k X H S b g

c . R e t r i b u s i P r a s a r a n a B a n g u n a n

V X 1 X l , C X > x H S p b g

d . R e t r i b u s i R e h a b i l i t a s i P r a s a r a n a

B a n g u n a n V x I x T k x H S p b g

K o t m u i c a n :

L : L u a s

I t : I n d c k s T e r i n t e g r a a i

H S b g ; H a r g a S a t u a n

B a n g u n a n G e d u n g

V : V o l u m e

I : I n d e k s

H S p b g : H a r g a S a t u a n

P r a s a r a n a B a n g u n a n

G e d u n g

T k : T i n f d c a t K c r u s a k a n

6 .

7 .

P r o d u k p c l a y a n a n S K 6 .





s m s sc r v u r. g p s , A T K d a n m o b i l .

8. K o m p e t e n s i p e i a k s a n a 1. Pe nge t ahuan

P e r d a N o 1 3 T a h u n 2 0 1 1 t e n t a n g

-6 5 -


R e t r i b u s i P e r i z i n a n T e r t e n t u

2. SI kap.

K o m u n i k a t i p , k c s i a b i l a n e m o a i ,

r e s p o n s i v e , k e t c l i t i a n , k e j p j u r a n ,

d i s i p l i n , k e r j s s a m a .

3, K s t r s m p U s n

- t e h n i k p c l a y a n a n p n m a .

9. P e n g a w a a a n i n t e m a l R a p a t s t a f s e t i a p b u l a n , l a p o r a n m e l a J u i


1 0 . P e n a n f j a n a n


m a s u t < a n ^





p e n g a d u a n ,






I t . • 1 1 1 1

J u m l a h p e i a k s a n a 6 o r a n g .

12. J a m i n a n p e l a y a n a n SOP




a c . t v . M e i a h e l p d e s k , C C T V


p e i a k s a n a

J K M t i a p 6 b u l a n .

K E P A L A D I N A S P E N A N A M A N M O D A L D A N

TENTANG PENETAPAN STANDAR PELAYANAN PERIZINAN …dpmptsp.boyolali.go.id/upload/download... · 2003 tentang Retribusi Pembenan Izin Usaha Rumah Makan dan Waruiig ... Izin Peruntukan

Documents