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STATE OF WISCONSIN )
WI�'NEBAGO COUN'ry � SS
)
' ` 0 4 e �74 ,L-�� /��r- /o /
(Na me). —�---' � �!!,- ! � �
being first duly sworn on oath deposes and�aa e�s )
a licensed plumber, and that he has applied for ahat he is not
permit to the Plumbing Inspector of the City of Oshkoshi�go d;,
plumbing work in a home owned and occupied b
th.at is being constructed tha� is owned b y him, or a home
b� occupied by him as his home when com letedm' and which wil�
building saic� home for the purpose of sale. �at he is nat
This affidavit is made for the
the provisions of the plumbing code of rthe�CitycofpOshkoshiand
�he State o� Wisconsin, which provides that all plumbing c,�o,��;
must be done by a licensed plumber except that the plumbing u���,�;_`
may be done by one who owns and occupies his own home
the installation comp1ies with the plumbing code of the rovidir.q
Oshkosh and the State of Wisconsin . ��ty o�
This affiant understands that the Plumbing work aut
by the permit applied for horized
that he cannot employ othersUwhobare�not�licensedhplumbersnt and '
as�ist with the work. �p �
Dated this � day o f �v �
--� � e
. i9�F�..
���P �
^/�'� V v��oy1,�,,
Subscribed and sworn to before me `
this day of
— , 19 ��
� � �_
: tlotary public, Winnebago County,
�lisconsin
�' My Commission Expires ; ��'� COm�+���+on �xp�res March �, 19�6