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FO^.WPB-3348 UNITED STATES OF AMERICA *10-26-N3> WAR PRODUCTION board STATEMENT OF CONFORMITY-TO UTILITIES ORDERS U-l-d OR U-l-h, OR WITH THE HOUSING UTILITIES STANDARDS BUDGET BUREAU NO. 12-R1604 APPROVAL EXPIRES SEPTEMBER 30, 1944 NAME OF UTILITY Vpjgsa Laud & Whim Go< ADDRESS (Street, City, State) 401 S<m*h tad Stars sf INSTRUCTIONS - Four (4) copies of this form should be filled out upon request of the Federal Housing Administration, Federal Public Housing Administration, U. S.D.A. County War Board, or War Production Board District Office. After it has been signed three (3) copies are to be presented to the builder, two (2) of them for insertion in his appli­cation file. This form supersedes Forms WPB-2710 (UF-26) and WPB-1290 ? (PD—545) for cases to which it is applicable. See additional instruc­tions on reverse side. itype of service requested O ELECTRIC ? JYATER ? GAS ? *^TEAM HEAT IDENTIFICATION OF BUILDER'S PROJECT Moxtus vf fifth & Btmmt NAME OF BUI LDER STATEMENT,0F UTILITY - THE UNDERSIGNED CERTIFIES EITHER (l) THAT UTILITY EXTENSIONS TO'SERVE fHE ABOVE TDENTIFIED PRO­JECT CAN BE BUILT UNDER THE CONDITIONS ESTABLISHED IN UTILITIES ORDERS U-l-d OR U-l-h, OR (2) THAT, IN CASES WHERE UTILITY EXTENSIONS TO SERVE DWELLINGS WILL COST MORE THAN $5,000, THEY CAN BE BUILT WITHIN THE HOUSING UTILITIES STAN­DARDS AND THE UTILITY WILL FILE AN APPLICATION WITH RESPECT TO THEM ON FORM WPB-2774* LAS VEGIlS nLAi® uAi'tiijrs i gnatui al SECTION 35(A) OF THE UNITED STATES CRIMINAL CODE, 18 U.S.C. SEC, 80, MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JUftl SOI CT1 ON. OPO— War Board 8350C— p. 1