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16410 SW 93rd Ave ."G-oSa, 0S 1( b6 a.+ CIS.- 6P o 54� /3///b Tigard High School Area Parking Permit Application Permit Period: September 2016—June 2018 1. Applicant name: Address: Tigard, OR 97224 Phone # 2. For proof of residency, attach a copy of a utility bill, real estate title or rental contract including name & address. 3. Attach a copy of the vehicle registration for each parking permit requested. � `1 Each household will receive 1 guest-parking permit. If you would like more than 1 guest- parking permit, how many would you like? I agree to use any parking permit(s) assigned to my vehicle(s) only on the specific vehicle it is assigned by the City of Tigard Police Department, for the purpose, it was issued. Any parking permit(s) remain the property of the City of Tigard and may be revoked if improper use is demonstrated. I agree to assign guest parking permit(s) to people only while visiting my home and surrender any rights if I move. Violation of any of these understandings may result in cancellation of the parking permit(s). After cancellation, any vehicle(s) found parked in the permit area bearing said parking permit(s) shall be cited. Signature Date Mail this application with proof of residency and vehicle registration(s) to: Tigard Police Department THS Area Parking Permits 13125 SW Hall Blvd. Tigard, OR 97223 ZCity of Tigard Service Address: 16410 SW 93RD AV UTILITY BILLING Customer Number: 010006-00 13125 SW Hall Blvd. j Tigard, OR 97223 1 1-888-826-7211 Service Type: RESIDENTIA TIGARD'S STRATEGIC VISIO\: "The most n'alkaGle conununih in the Pacific:\'orllm•esl Meter Size: 5/8 where people of all ages and aGililies enjoy henhln and iJrtercomJecrecilives." Service Dates: 06/27/2016 to 07/25/201, DUE DATE: August 24, 2011 BI I I I ng Su 1'111T1a ry For an explanation of each charge,please see the reverse side of this bill. WATER CHARGES: Water Consumption 10 CCF (Current Meter Read 3,874 Previous Meter Read 3,864) $40.86 Customer Base Charge $26.67 TOTAL TIGARD WATER CHARGES: $67.5: .......... .............................................................................................................................................................................. ... SEWER AND SURFACE WATER CHARGES: Sewer Usage Charge Based on your Winter Average of 5 CCF $9.08 Sewer Base Charge $27.36 Surface Water Management Charge $9.75 TOTAL SEWER AND SURFACE WATER CHARGES: $46.1' ............................................................................................................................................................................................... OTHER CHARGES: Residential Street Maintenance $5.30 Residential Parks& Recreation Fee $3.75 TOTAL OTHER CHARGES: $9 0, ..........................................................................................................................................................................................9..., Compare Your Water Usage TOTAL CURRENT BILLING: $122.77 CCFs Water consumption is charged per 100 cubic feet(or CCF).Each CCF=748 gallons. PRIOR BILLING: 40 Previous balance(as of July 25, 2016): -$8.9E 32 Adjustments: $0.010 24 Payments received-thank you: $0.010 16 TOTAL PRIOR BILLING: -$8,96 8 TOTAL DUE: $113.81 o JJ � J —■ JJJJ AUG'15 SEP'15 0Cr15 NOV'15 DEC15 JAN'16 FEB'16 MAR16 APR'16 MAY'16 JUN'16 JUL'16 ■ Current Year Previous Year Last year's water usage in same billing period: 17 CCF r----------------------------------------------------------------------- DISCOVER THE BENEFITS-SKIP THE CLUTTER AND SAVE THE PAPER.WITH OUR CONVENIENT PAPERLESS BILLING YOU RECEIVE YOUR BILL ONLINE AND GET AN EMAIL NOTICE WHEN IT'S READY.VIEW YOUR BILL ANYTIME,VIEW PAST BILLS,AVOID LOST OR MISPLACED BILLS AND HAVE THE CONVENIENCE OF SEEING ALL THE INFORMATION ASSOCIATED WITH YOUR UTILITY ACCOUNT.IT'S A SUSTAINABLE,EARTH-FRIENDLY CHOICE.SIGN UP AT ————————————————————————— HTr PS://TIGARD.MERCHANTTRANSACT.COM ---� ---------------------- Please return this portion with payment. Please DO NOT staple or tape check to the coupon. ❑ FOR CHANGE OF ADDRESS,PLEASE CHECK BOX AND COMPLETE FORM ON REVERSE SIDE. City Df Tigard I UTILITY BILLI\G 13125 SW Hall Blvd. Tigard, OR 97223 DUE DATE: August 24, 2016 e y TOTAL DUE: $113.81 ADDRESS SERVICE REQUESTED Service Address: 16410 SW 93RD AVE Customer Number: 010006-000 2114 1 AV 0.376 51380 02141 0001:0001 Make check payable to:City of Tigard. I'I�'I'�'I�I�I��'III'��I�"��III�I���'ll'I�III�IIFIIIFIII'I'I�'ll 503-718-2460 www.tigard-or.aov CRAIG & ILENE OLSON 16410 SW 93RD AVE ` * 'III"II��IIIIIII"I�I�I'�'11111!'IIIIIIII�I'll'lll'�II'1'll"'�I TIGARD OR 97224-5596 CITY OF TIGARD P.O. BOX 3129 ,. f PORTLAND, OR 97208-3129 101010006000000000000113817 '� PASSENGER REGISTRATION CARD PLATE NUMBER TITLE NUMBER FUEL TYPE FARM ID NO. NEW EXPIRATION DATE 986FDR 11115466024 , GASOLINE I MAY 9 , 2017 YEAR MAKE STYLE �110DEL VEHICLE IDENTIFICATION NUMBER HVUT DATE 2012 MAZD SW Z5 JMICW2BL8C0104318 FEE EQUIPMENT NO. WEIGH /LENGTH TITLE BRANDS - NONE - $86 . 00 ODOMETER READING ODOMETER DATE ODOMETER MESSAGE •rte fL *OLSON, ILENE KARIN oy OLSON, CRAIG RUSSELL r t 16410 SW 93RD AVE COUNTY OF RESIDENCE COUNTY OF USE TIGARD OR 97224-5596 WASHINGTON NEW ADDRESS(HOUSE NUMBER,STREET,CITY,STATE,ZIP CODE) VALIDA,7,(Njy,019PI5945 NEW PLATES NUMBER INXII29664 OREGON PASSENGER REGISTRATION PLkT tiJ�ABEP. TITLE NUMBER PROCESS DATE JEXP'RA-U DATE 1 �L 7YPE EQUIPMENT NO. 428HRD 1520930152 072815 JUN 12 19 � HYBRID "EAR. I MAKE STYLE I MODEL VEHICLE ILIENTIFICA71ON NUMBER WEIGHTILENGTH 20151 TOYT SW PRI JTDZN3EUXFJ031068 TITLE BRANDS - NONE - ODOVETER READING ODOMETER DATE OWNER; 3 06/12/15 LESSEE ODOMETER MESSAGE OLSON, CRAIG RUSSELL OLSON, ILENE KARIN 16410 SW 93RD AVE TIGARD OR 97224 COUNTY OF COUNTY of RESIDENCE USE NEW WASHINGTON ADDRESS OREGON PASSENGER REGISTRATION PLATE NUMBER TITLE NUMBER PROCESS DATE EXPIRATION DATE IFUELTYPE EQUIPMENT NO. 778HNE 11533578353 120115 JUN 22 , 19 GASOLINE YEAR j MAKE STYLE I MODEL VEHICLE IDENTIFICATION NUMBER WEIGHTILENGTH 2015 MAZD 14D MZ3 JMIBM1M77F1267911 TITLE BRANDS - NONE - ODOMETER READINGODOMETER DATE OWNER/ 20 06/27/15 LESSEE ODOMETER MESSAGE OLSON, HANNAH REBECCA 16410 SW 93RD AVE T I GARD OR 97224 COUNTY OF COUNTY OF RESIDENCE USE NEW WASHINGTON ADDRESS REMARKS: 13ATTE Notice of Transaction TIT gpVEPAM1gTeP VEKKIE HEPVCES Submitted lrer Uro AYE PE.SALEY OPEeeY ara11 REG/RE FEE PLATE CODE AN E I VT, TI ORG MP PROC=ESS EX MIS= TITLE BRAND 1 J VIN FEE PERMIT# MEMORANDUM RECEIPT# VIN INSPECTION:❑ DATE/INITIALS: DEALER TWINS PRE CHECKER LEV COMPLIANT: ❑YES[]NO ❑ LATE TITLE FEE NEW PLATE# STICKER# VEHICLE IDENTIFICATION NUMBER(VIN) OREGON TITLE# O WMWRE33556TJ36873 1436521614 REPLACEMENT FEE PRESENT OREGON PLATE EXP IR ON T6 VEAR MAKE STYLE REGWEIGHT/LENGTH GVWR OVER ❑YES pIATETRANSFER 264 HG"T ! 1' 2006 MY\1 2D 2678 zs,DOO LBS. E]NO O FARM ID# FLEET ACCOUNT q EQUIPMENT# ®'GAS ❑DIESEL —]HYBRID ❑HYBRID ❑FLEX-FUEL RAILER OVER❑YES TOT 3 ❑ELECTRIC [—]PROPANE ❑GAASURAL ❑OTHER: ,000 LBS. ❑NO ODOMETER: Federal and State laws require(hat you stale the mileage when you transfer ownership on a vehicle 9 years old or newer.Failure to complete an odometer disclosure or providing a false statement to meet this requirement is a Class C felony under ORS 815.430.Use this certification when required to provide the odometer disclosure but unable to provide the proper disclosure from the seller.I certify the odometer disclosure listed is true and correct and a disclosure is not available on the required form from the seller. Providing an odometer reading for a vehicle 10 years old or older is Ovoluntary. I certily that,to the best of my knowledge,the odometer reading is actual ODOMETER READING(NO TENTHS) DATE OF READING(MM/DD/YYYY) mileage UNLESS one Witness,boxes is marked: 13 9100 V O�G Ci�2U I�� ❑ the mileage staled is in excess of its mechanical limits(has rolled over);or ❑ the odometer reading is NOT actual mileage.WARNING-odometer discrepancy. Complete Line 5 with the owner whose address will be used for all DMV mail regarding this vehicle. List additional owners on Lines 8 and 9.(This In noway detemrines a priority of ownemhlp,)If any owner listed uses a work address on DMV records.that owner must be shown on Line 5.See reverse for more interna lon. PRINT FULL LEGAL NAME LAST,FIRST,MIDDLE OF(check one) r:}'OWNER OR ❑LESSEE O OLSON, BENJAMIN, KAPLON LJ RESIDENCE/BUSINESS ADDRESS(Address will be used to update your CDL/ID card) MAILING ADDRESS(d dttsreat tram residence-will be used to update your ODL/ID card) © 16410 SW 93RD AVE CITY,STATE,ZIP CODECOUNTY OF RESIDENCE CITY,STATE,ZIP CODE COUNTY OF MAILING T IGARD, OREGON, 97224 WASH1NJGT0i`,1 OJOINT OWNER OR LESSEE-PRINT FULL LEGAL NAMELAST,FIRST,MIDDLE(See'Changeof Address°sn reverse) 8 �\ JOINT OWNER OR LESSEE-PRINT FULL LEGAL NAME:LAST,FIRST,MIDDLE(See'Change of Address'on iN ONE-TIME MAILING ADDRESS SII not change your customer rewrd) Reg: niy VEHICLE ADDRESS-(Location of vehicle it different Irrnn residence). 10 ❑Title Only Both CITY,STATE,ZIP CODE CITY.STATE.ZIP CODE COUNTY(of vehicle address or use) TT AV C- �J ���(42