9227 SW Martha St ��obs
Tigard High School Area Parking Permit Application
Permit Period: September 2016—June 2018
1. Applicant name: (�ka J , Tco o-v"(— Rd zk.e
Address: 0 3 7 SO N\c_r+K,
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
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: 9227 SW MARTHA ST
v UTILITY BILLING Customer Number: 030740-001
13125 SW Hall Blvd. Tigard, OR 97223 1-888-826-7211 Service Type: RESIDENTIAL
Meter Size: 5/8"
• TIGARD'S STRATEGIC VISION: "The most walkable community in the Pacific Northwest Service Dates 06/27/2016 to 07/25/2016
where people of all ages and abilities enjoy healthy and interconnected lives."
Billing
DATE: August 24, 2016
®o!(Ing SUmmary For an explanation of each charge,please seethe reverse side of this bill.
WATER CHARGES:
Water Consumption 6 CCF (Current Meter Read 2,402 Previous Meter Read 2,396 ) $20.70
Customer Base Charge $26.67
TOTAL TIGARD WATER CHARGES: $47,37
................................................................................................................................................................................................
SEWER AND SURFACE WATER CHARGES:
Sewer Usage Charge Based on your Winter Average of 7 CCF $12.71
Sewer Base Charge $27,36
Surface Water Management Charge $9.75
TOTAL SEWER AND SURFACE WATER CHARGES: $49,82
.................................................................................................................................................................................................
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: $106.24
CCFs Water consumption ischarged;per 100 cubic feet(or CCF):Each'CCF='748 gallons. PRIOR BILLING:
1s Previous balance(as of July 25,2016): $122.65
12Adjustments: $0.00
9 Payments received-thank you: -$122.65
6
_ r TOTAL PRIOR BILLING: $0.00
3 ' Viµ; TOTAL DUE: $106.24
:AUG'15 SEP115 OCP15 NOV'15 DEC15 JAN'16 FEB'16 MAR'16 APR'16 MAY'16 JUN-16 JUU16
■ Current Year Z Previous Year Last year's water usage in same billing.period: 13 CCF
r----------------------------------------------------------------------8
DISCOVER THE BENEFITS-SKIP THE CLUTTER AND SAVE THE PAPER.WITH OUR CONVENIENT PAPERLESS BILLING YOU RECEIVE YOUR BILL ONLINE AND GET AN i
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
1 HTTPS://TIGARD.M E RCHA NTTRA NSACT.CO M
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t
OREGON
PASSENGER REGISTRATION
PATE NUMBER TITLE NUMBER PROCESS DATE EXPIRATION DATE IFUELTYPE EQUIPMENT NO.
L
255GGB 1310752643 041 J�1 3 P�FAF. .16, 17 FLEXFUEt WEIGHT/LENGTH
YEAR MAKE STYLE MODEL VEHICLE IDENTIFICATION NUMBER
2013 JEEP 4W WF'G 09747
TITLE BRANDS_... - NONE -ODOMETER READING ODOMETER DATE
22 03/16/.13
JJNER/ °ti+/ ODOMETER MESSAGE
PATZKE, CHAD
PATZKE.P TREENA A��
9227 SW MARTHA ST "+
� � 0 ' 97224�� �,; � �� COUNTY OF COUNTY OF
RESIDENCE USE
WASHINGTON
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DDRESS