HomeMy WebLinkAbout009632-Electric :
s
C�J � �
C� � b� �
r-I . a'� � a
o� �a
� rd N. z c
H � r� � � �
� A U; �" � ,;; -° �;
+. o w
��' r�,I'c �� z � �
� o�a p'
� � �0 >A c �
�d'e q �
O �; w :�
O ►� � �: I a
�e a •�: ` �
..c c/]E o �a a�i
o ►--a w d� �
a o
.a.. � �
O c
�. r � ° z ,�
'" \J �
V h--�1 0 �o � ;.�3
� � � �d
Z � .� � � `' _:�
O O : °�° ° ai o
�, �r � •� � � .� �, x � �"�
V GL a�'i i-� N A U tn a� �:•s�*.
� � d � $ o � � + � w' •�
ca O �:e�
� � � � � � � � � � ,�
O r� v� W 0: ,C
O � : c°�.
� �d o: �
�- �, •
V O .a3i :.,c+ .� rj; a
W � �� �y CJ {J}: W .
ii /� 6� {,�' � '
N / � .� �W d� � ' d
? � � � a d � a
v! : 3 �' � � .
J O :'�. , �
a�:
cC
a � �: z � '�� o
U r ' s� �, � �
� C..'� � � �c �..��. � � �y >.
� " ."
(� [—, � cs"''3 �: a�i y pq s• � � rl ,: o
W [ '� �+ ,�e o m t� � d � � � : y
J F---1 � +�; � a`�i d x �°, � �
W .� �' e. e,� .c� �.4' ..�'. � ' o
� : o x � d � �, „� ��
� +-': a :� � a °' ;, H� �� � � .°� � :a
�/ �a � � � a o� �07 �+ v �o � :o
11,' �.1..� a�'i N: � � f� � � A �C o U o '3 Q' A ; ;�
�T� ` 3: :a
a � �'ti
w/� � � oL •� �+; o 'd a :� >
r� F� 0 0 '� N: — :^3 d :s.
P4 F� � A: b w x = :,�
� p" s. � :..,
- a 'O �ri: � Gy y d � iQ�'
,a,, .�; c. � �
r
Z '''' .r�-li � a A � �.,�
� �� �-I : m r-� (V r� : :C ..
-� � �1-�: N : z A o ; _�,
� �� Q a' �� : � : - � o � o
V ' �: 3 : ^' aa c ' :q
� 'b: N: Q ' �i O 3 O : :�
�� F- r-I: rn c a y „� �n : :'�
�,�x , k� V rd; F � A � � � �o :'a
W �+i � c`� s. id o ....
J N: � m vi e� y
u� C9. N � d ; .� �3 eo 3 m .� o '� :w
�a c. '�, �
r� � � q ,��$ � � � � � � � � ~ : 'y :
V : z U �+ m f� C� C� A � � H > � c�
AFFIDAVIT RELATING TO SECTION 13•12 (c ) OF A GENERAL OADINANCE
OF THE CITY OF OSHKOSH RELATING TO THE LICENSING �F ELECTBICIANS
AND PROVIDING PENALTIES •
STATE OF WISCONSIN}
WINNEBAGO COUNT�C ) SS
.�
, , --- �
_ , ���- u/ � �,-� ,
N8� Address
first being duly sworn on oath, deposes and says that he is not
a 2loensed electrician in the Clty of Oshkosh and that he has
applied Por an electrical permit to do electrical work in a
residence and/or auxiliary buildings (intended solely for pur-
poaes assooiated xith a residence) which is owned and occupied
by him, or is being constructed in his 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 electricai work but members of his immediate
famiZy.
Dated this �c�--- day of
, 19 >;�
. ����..�
Subscribed and sworn to before
this �_ dgy of
----.-._� �._._� 19,..._,•
.
Notary Pub11c, Winnebago County, Wisconsin �
.
My Commission Expires: