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AFFIDAVIT RELATING TO SECTION 13.12 (c) OF A GENERAL ORDINANCE
OF THE CITY OF OSHKOSIi RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
WINNEBAGO COUNTY ) SS
rQ O L- L (J ~ ~J~
Name ~ Addre s
first being duly sworn on oath, deposes and says that he is not
a 2lcensed electrician Sn the City of Oshkosh and that he has
applied for an electrical permit to do electrical work ,in a
residence and/or auxiliary buildings (intended solely for pur-
poses associated with a residence) which Ss owned and occupied
by him, or is being constructed in #~is 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~snd that he cannot employ others to
assist with the electrical work but members of his immediate
family.
Dated thi s _ c~ r,~ day of ~~
..._._....."_ ~ 1 ~~.
Subscribed
t
and sworn to before
19 ~.
thi s' ~k~ day of
Notary Public,
My Commission
Winnebago County, Wisconsin
Ex i re s ; ~ CUMMISSION EXPIRES
P JULY 20, 1981