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AFFIDAVIT RELATING TO SECTION 13.12 (c) OF A GENERAL ORDINANCE
OF THE CITY OF OSHKOSH RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY )
;0 c "t1::4l
h41?~jC/( ,
1
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/ c;:( 6
IVEs!
(Address)
CUSTK-t-<. A--rP
first being du17 swo'rn ono~th, deposes and says that he is not
a licensed electrician in t~e City of Oshkosh and that he has
applied for an electrical permit to do electrical work ,in a
residenoe and/or auxlliarybuildings (intended solely for pur..
poses associated with a residence) which is 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 electrical 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 'out members of his immediate
family.
Dated this 2?
day of
au L-v
/
, 194.
Subscribed and sworn to
. JfdJj UM~p
before
, 19ffl.
,.,
"
My Commission Exp1res:
County, Wlsc6nsln
MY CO~MISSION EXPfRES
JULY 1<1, 1985'