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upr000033-098
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“ fV ^ m W P B - 3 3 4 8 U N I T E D S T A T E S OF A M E R I C A W A R P R O D U C T I O N B O A R D S T A T E M E N T O F C O N F O R M I T Y T O U T I L I T I E S O R D E R U - l - d , O R W I T H T H E H O U S I N G U T I L I T I E S S T A N D A R D S B U D G E T B U R E A U N O . 1 2 - E 1 6 0 4 . I A P P R O V A L E X P I R E S M A R C H 3 1 , 1 9 4 3 N A M E O F U T 1 L I T Y A D D R E S S (Street, City, Zone, Sta te) 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 y copies are to be presented to the builder, t w o (2 ) of them for insertion in his appli­cation file. SEE ADDITIONAL INSTRUCTIONS ON REVERSE SIDE T Y P E O F S E R V I C E R E Q U E S T E D / ? E L E C T R I C l~n r~l G A S | | W A T E R l l l i l H E A T I D E N T I F I C A T I O N O F B U I L D E R ’S P R O J E C T Warehouse building, Lae Vegas, Neruda. N A M E O F B U I'tDER 0 . A . Huffey T H E U N D E R S I G N E D C E R T I F I E S E I T H E R (i) T H A T • U T 1 L I T Y E X T E N S I O N S T O 'SERVE T H E A B O V E I D E N T I F I E D P R O ­J E C T C A N B E B U I L T U N D E R T H E C O N D I T I O N S E S T A B L I S H E D I N U T I L I T I E S O R D E R li-l-d, O R (2 ) T H A T , IN C A S E S W H E R E U T ! > ITY E X - I g g M B M B S E R V E D W E L L I N G S W I L L C O S T M O R E T H A N $ 1 0 , 0 0 0 , T H E Y C A N B E B U I L T W I T H I N T H E H O U S 1 N G v U T 1 L 1T 1E S S T A N D A R D S A N D T H E U T I L I T Y W I L L F I L E A N ' A P P L I C A T 1 O N W I T H R E S P E C T T O T H E M O N F O R M W P B - 2 7 7 4 . / \ Las V e g a s Land a n d Water Coup any RY 7 r v 7 i ^ < ^ N A M E OF U T I L I T Y S I G N A T U R E O F A.UT H O R 1 Z E D O F F 1 C 1A L January 3# 19^5 Vice President D A T E B n i \ T I T L $ S E C T I O N 3 B ( A ) O F T H E U N I T E D S T A T E S C R 1 M 1 N A L C O D E , 1 8 U .S . C . S E C . 8 0 , M A K E S IT A C R I M I N A L Q F F E N S E T O M A K E A W 1 L L F U L L T F A LS E S T A T E M E N T O R R E P R E S E N T A T I O N T O A N Y D E P A R T M E N T O R A G E N C Y O F T H E U N I T E D S T A T E S A S T O A N Y M A T T E R W I T H IN 1T S J U R I S D I C T I O N . <>rn- W a r B o n n l 12871 K— p. 1