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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)
WINNEBAGO COUNTY , SS
ame ~ Adare ss
first being duly awo~rn on oath, deposes and says that he is not
a 2laensed electrician in the City of Oshkosh and that he has
`applied for an electrical permit to do electrical work .in a
residenoe and/or auxiliary buildings (intended solely for pur-
poses associated with a residence) which is owned and occupied
by hlm, or is being constructed in his ngme, 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 a ectrical work but members of his immediate
family.
Dated this ~~_ day of ~~/-~~C~
Subscribed and sworn. to before
thi s )' day of 1
_...._,._ ~ 19~.
Notary pub~.ic,.Winnebago County, Wisconsin
MY COMMISSION EXPIRES
My Commission Expires: ~u~Y 20, i98i