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AFFIDAVIT RELATING TO SECTION 1).12 (c) OF AGE~~ ORp~NAJJCE
r~ OF THE CITY 'OPOSHKOSIiBEU1'!NG TO. .TBELI~ENSING OF El$CTRICIANS
AND PROVIDING PENALTIES.
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY )
~E',tJ hf2~fIJV6HOrF
,
/,33d, 1Sfl1I1~C~
Address )
first being duly sworn on oath, deposes and says that he is not
a 110ensed electric1an in the City of Oshkosh and that he has
appl1ed for an eleotrioal perm1t to do electrical work in a
residenoe and/or auxiliary buildings (intended solely for pur-
poses assooiated with a residence) Which 1.s owned and occupied
by him, or is being constructed in his name, as his personal
home and that said residence or aux11iary buildings being so
wired are not to be used or erected for rental purposes or for
resale to present or prospective purchasers.
Affiant understands that the electrical work autho:rized by
the permit applied for 1n connection w1th :this affidavit, must
be done only by this affiant and that he c~nnotemployothers to
assist with the electrical work but members of his immediate
family.
Da ted thi s ~~/f~=3 day of
, 19__
Subscribed and swcrn to befO~~~VH/H~
th:/1~ ~~ ' 194B.
Notary Public, -W1nnebago/_c,Z. n)v. $:d.isconsin
My Commission Expires: ~.~~L
~
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