HomeMy WebLinkAbout0009642-Electric (service change) CV =
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AFFIDAVTT RELATING TO SECTION 13•12 (a ) OF A GENEAAL ORDINANCE
OF THE CiTY OF OSHKOSH RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES '
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY )
v v�Il� S L M�' , Z 21� � �t 1.�}r�Q � D
NameT Addre s s
first being duly sworn on oath, deposes and says that he is not
a lioensed electrician in the City of Oshkosh and that he has
applied Por an electrical permit to do electrical work in a
reeidence and/or auxiliary buildings (intended solely for pur-
poses asaoolated Kith a residence) which is owned and occupied
by him, or is being construeted in his naoe, as his personal
home and that said resldence 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 Lhis affidavit, must
be done only by this afflant and that he cannot employ others to
assist with the electrlcal work but members of his immediate
family.
Dated thi s 2-� day of J'�ll�- Y � 1,9��
�
�
Subscribed and sworn to befor
thi s � day of ���, 19 %?�
�Gl/t�n� � .���'�- �
Notary Pub11c, Winnebago County, Wisconsin
My Commi s s 1 on Expi re s: � MARCH 12N197�3 R�S