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��,FFIDAVIT BELATING TO SECTION 13.12 (c ) OP A GENEAAL OADINANCE .
OF THE CITY 4F OSffi{OSH AELATING TO THE LICENSING OF ELECZ'F�ICIANS �
AND PAOVIDING PENALTIES `
�
STATE OF WZSCONSIN) �
� ) SS =
WINNEBAGO COUNTY )
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� (.� �i/� � 1 v ��r � �
Name Address � #
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f2rst being dul� sworn on oath, deposes and says that he is not a
a 2laensed electrician in the City of Oshkosh and that he has
applled for an electrical permit to do electrical work ,in s
residenae and/or auxiliar�r buildings (intended solely for pur-
poses asaociated with a residence ) which is owned and occupied �
bq him, or is being canstructed in his name, as his personal f
home and that said residence or auxiliary buildings be�ng 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 th2s affiant and that he cannot employ others to � k
assist with the electrical work but members of his immediate � �
faaily. �
Dated this ��# day of fi � , 19�� �;
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Subscribed and sworn to before k
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otary p c, Winneb o County, Wisconsin
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My Cammission Expires:�� ���� �
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