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w p&i WPB-3348 (9_22-im) UNITED STATES OF AMERICA WAR PRODUCTION BOARD STATEMENT OF CONFORMITY TO UTILITIES ORDER U-l-d, OR WITH THE HOUSING UTILITIES STANDARDS INSTRUCTIONS - Four (4) copies of this form should be filled out upon request of the Federal Housing Administration, Federal Public Housing Administration, D.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. SEE ADDITIONAL INSTRUCTIONS ON REVERSE SIDE BUDGET BUREAU NO. 13-PI 6 04.1 APPROVAL EXPIRES NARCB 31. 1943 NAME, OF UT 1 L ITY ADDRESS (Street City, Zone, State) mi Sv. its*! Ife* TYPE OF SERVICE REQUESTED ? ELECTRIC B WATER ? GAS ? STEAM HEAT NAME OF 8UILDER IDENTIFICATION OF BUILDER’S PROJECT m U' v e nn wan 2k$# tein By Wsrmn Sil^ -me STATEMENT OF UTILITY -THE UNDERSIGNED CERTIFIES EITHER (l) THAT UTILITY EXTENSIONS TO SERVE THE ABOVE IDENTIFIED PRO­JECT CAN BE BUILT UNDER THE CONDITIONS ESTABLISHED INUTILITIES ORDER U-l-d, OR (2) THAT, IN CASES WHERE UTILITY EX­TENSIONS TO SERVE DWELLINGS WILL COST MORE THAN $10,000. THEY CA'N BE BUILT WITHIN THE HOUSING UTILITIES STANDARDS AND THE UTILITY WILL FILE AN APPLICATION WITH RESPECT TO THEM ON FORM WPB-277N. NAME OF UTILITY FEB -7 1945 SI8NATURE OF AUTHOR If ED OFFICIAL GENERAL MANAGER OATE T IT LE SECTION 31 (A) OF THE UNITED STATES CRIMINAL CODE, 18U.S.C. SEC. 80, MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FA LSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION. GPO— War Board 13871H— p. l