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AFFIDAVIT RELATING TO SECTION IJ.12 (c) OF A GENERAL ORDINANCE
OF THE CITY OF OSHKOSH RELATING TO THE LICl;NSING OF. ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY )
~_1
,
If1cJ-( . -Sc/lRo EJ!)EtIf,
( Name ) . .
. , ~
',/3/{Jff~~4ARk /f-j/C
f1rst be1ng duly swo'rn onoE.:!-th, deposes and says that he is not
a lioensed electrician 1n ti1e City of Oshkosh and that he has
app11ed for an electr1cal permit to do electr1cal work.in a
residenoe and/or auxiliary buildings (inte~ded solely for pur-
poses associated with a residence) which 1s owned and occupied
by him, or is being constructed in nis name:, as his. personal '
home and that said residence or auxiliary 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 electrica;J. work authorized by
,the permit applied for in connection with this affidavit, must
be done only by this affiant 'and that he cannot employ others to
assist with the electrical work but members ofh1s lmIXIed1ate
fam1ly.
Dated th1s
b
day of
qULV
Y
, 19~.
lJ~R~
,
Sub:;;cribed a.nd sworn to before
this 0~Q:;; ~~J~Od · 19&.
Notary Public, iJ'1nnebago County, \v1 scons1n
MY COMMfSSION EXPIRIiS
My Commiss1on Exp1res:- JUL:.Y 20, HHU