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ELECTRICAL AFFIDAVIT UNDERGROUND DATE PERMIT # STATE CARD # SUBDIVISION ADDRESS LOT # This affidavit is for the installation of electrical at the above location. I/We (contractor) understand it is my/our (contractor) responsibility to ensure that the installation is in accordance with the current edition of The National Electrical Code (NEC)as adopted by DCA. The City of Cartersville is relieved of all inspections and liability for damages, loss of property or cost due to improper installation. Business Name & Address Notary Public (Seal) Signature NOTICE: Per Sec. 24-6 City of Cartersville Code of Ordinances a tracer wire is required in all underground utilities that are nonmetallic. P.O. Box 1390 10 North Public Square Cartersville, GA. 30120 Phone: [PHONE REDACTED] www.cityofcartersville.org