16520 SW 93rd Ave Tigard High School Area Parking Permit Application
Permit Period: September 2016—June 2018
1. Applicant name: `tiC:�'1 '�
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.
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 1 `
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
City of Tigard Service Address: 16520 SW 93RD AVE
w UTILITY BILLING Customer Number: 010011-000
13125 SW Hall Blvd. I Tigard, OR 97223 1 1-888-826-7211 Service Type: RESIDENTIAL
B TIGARD'S STRATEGIC VISION: "The most walkable communio-in the Pacific Northwest Meter Size: 5/8°
where people of all ages and abilities er joy healthy and interronnected lines." Service Dates: 07/25/2016 to 08/29/2016
DUE DATE: September 28, 2016
BillingSummary For an explanation of each charge,please seethe reverse side of this bill.
WATER CHARGES:
Water Consumption 12 CCF (Current Meter Read 5,617 Previous Meter Read 5,605) $50.94
Customer Base Charge $26.67
TOTAL TIGARD WATER CHARGES: $77.61
.................................................................................................................................................................................................
SEWER AND SURFACE WATER CHARGES:
Sewer Usage Charge Based on your Winter Average of 6 CCF $10.92
Sewer Base Charge $27.45
Surface Water Management Charge $9.75
TOTAL SEWER AND SURFACE WATER CHARGES: $48.12
................................................................................................................................................................................NN............
OTHER CHARGES:
Residential Street Maintenance $5.30
Residential Parks&Recreation Fee $3.75
TOTAL OTHER CHARGES: $9.05
................................................................................................................................................................................................
Compare Your Water Usage TOTAL CURRENT BILLING: $134.78
CCFS Water consumption is charged per 100 cubic feet(or CCF).Each CCF=748 gallons. PRIOR BILLING:
25 Previous balance(as of August 29,2016): $178.58
20 Adjustments: $0.00
15 Payments received-thank you: -$178.58
TOTAL PRIOR BILLING, $0.00
10 W,
TOTAL DUE: $134.78
rY :
SEP115 ocr'is NOv'15 DEC15 JAN 16 fn'16 MAR'16 AMU MAY'16 NN'16 JUV16 AUG-16
■ Current Year E;Previous Year Last year's water usage in same billing period: 10 CCF
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1 The average customer will see an increase of$2.07 on the sewer base charge beginning Oct.1,2016.Council adopted this increase to keep up with rising costs of regular 1
1 maintenance of the sewer infrastructure.City officials and staff recognize the financial challenges facing many customers;we remain dedicated to providing high quality 1
utility services at a reasonable cost.For details about the fees on your bill,visit:www.tigard-or.gov/UB. 1
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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 o,f Tigard I UTILI'T'Y BILLING
13125 SVS/Hail Blvd.
WE
Tigard,OR 97223 DUE DATE: September 28,2016
TTL UE: $134.78
ADDRESS SERVICE REQUESTED Service Address: 11;520 SW 93RD AVP> `
Cust+briier Nurribeir° 010011-000
2247 1 AV 0.376 51338 02261 0001:0001 Make Check payable to.City of Tigard.
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TIGARD OR 97224-6513 CITY OF TIGARD
P.O. BOX 3129
PORTLAND,OR 97208-3129
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