HomeMy WebLinkAbout0001128 Electric (Service)AFFIDAVIT AELATING TO SECTION 13.12 (c) OP A GENERAL ORDINANCE
OF TEiE CITY OF OSHILOSH RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY )
//��/"� / _ivN����% � ,�0>2 S C�'�� / ,� "t
Nama�� Addre s s
flrst being duly sworn on oath, deposes and says that he Ss not
a 2lcensed electriclan Sn the CSty of Oshkosh and that he has
applied for an electrlcal permit to do electrlcal work ln a
residence and/or auxiliary bulldings (Sntended solely for pur-
poses associated wlth a resldence) which ls owned and occupled
by him, or Ss beSng constructed in his name, as hls personal
home and that said residence or auxlliary buildings being so
wired are not to be used or erected for rental purposes or for
resale to present or prospective purchasers.
Afflant understands that the electrical work authorized by
the permlt applled for in connection wlth this affldavit, must
be done only by thls afflant and that he cannot employ others to
assist wlth the electrical work but members of his Smmediate
faolly.
Dated this .__�% day of /�dl��=i"/OiL�n � 19%�.
�� C!- �-, -� �-f�
Subserlbed and sworn to before
thls � day of �'��i'����i'��';i , 19�.
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P7otary Publlc, Winnebag�County, Wisconain
MY COMMISSION EXPIRE$
My Commission Explres: lu�r 20. iesi