664852-1887-Public-Health-Bill-2nd-Reading — Page 16

Government Gazette 政府憲報 轅門報 All

880 SUPPLEMENT TO THE HONGKONG GOVT GAZETTE OF 23RD JULY, 1887.

Situation of Lodging-

House and Street

Number thereof.

Schedule C.

Form of Common Lodging-House Register.

Maximum No.

Name of

Keeper.

Signature of Registering Officer.

No. of

Sleeping

Rooms.

Kitchens. No. of

No. of

Closets.

Nature of Water Supply.

of Lodgers which can be received.

Register

Tlate.

Number.

Schedule D.

Application for a House to be registered as a Common Lodging-House I, the undersigned, hereby make application to have the under- mentioned premises registered as a Common Lodging-House, under the Public Health Ordinance of

1887.

Signature of Applicant,..

Address,

Hongkong,

188

Situation of premises sought to be registered as a

Common Lodging-House,........

The number of floors to be used as a Common

Lodging-House,

The number of rooms set apart for lodgers,

Cubic capacity of Room No. 1...

................................cubic feet.

Do.

do.

No. 2,..

do.

Do.

do.

No. 3...

do.

Do.

do.

No. 4...

do.

Do.

do.

No. 5,...

do.

Do.

do.

No. 6,.....

do.

To the Registrar General.

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