9260 SW Millen Dr GP- o
1016 AUG 12 PH 3: 22
Tigard High School Area Parking Permit Application
Permit Period: September 2016—June 2018
1. Applicant name: -\( CJI-
Address: �2�y
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 ermit. If you would like more than 1 guest
e?
permit, how many would you like? . J
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.
CID, 2
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: 9260 SW MILLEN DR
UTILITY BILLING Customer Number: 027576-000
® 13125 SW Hall Blvd. I Tigard, OR 97223 1 1-888-826-7211 Service Type: RESIDENTIAL
Meter Size: 5/8"
. ® TIGARD'S STRATEGIC VISION: "'The 1170st walkable connnunitP in the Pacific Nol-thi est Service Dates 06/27/2016 to 0Size: 016
mherelleople gfall ages incl abilities el joy healthv and interconnecte'd lives_"
DUE DATE: August 24, 2016
Billinga r For an explanation of each charge,please seethe reverse side of this bill.
WATER CHARGES:
Water Consumption 14 CCF (Current Meter Read 3,762 Previous Meter Read 3,748) $61.02
Customer Base Charge $26.67
TOTAL TIGARD WATER CHARGES: $87.69
.................................................................................................................................................................................................
SEWER AND SURFACE WATER CHARGES:
Sewer Usage Charge Based on your Winter Average of 6 CCF $10.89
Sewer Base Charge $27.36
Surface Water Management Charge $9.75
TOTAL SEWER AND SURFACE WATER CHARGES: $48.00
.................................................................................................................................................................................................
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: $144.74
CCFS Water consumption is charged per 100 cubic feet(or CCF).Each CCF=748 gallons. PRIOR BILLING:
30 Previous balance(as of July 25, 2016): $144.31
24 Adjustments: $0.00
18 Payments received-thank you: -$144.31
12
TOTAL PRIOR BILLING: $0.00
` -
TOTAL DUE: $144.74
AU6`15 SEP115 OCT`15 NOW15 DEC15 JAN'16 FEW16 MAR'16 APR'16 MAY'16 JUN'16 JUU16
® Current Year , Previous Year Last year's water usage in same billing period: 25 CCF
r—r---e--r—®—r--ee----®—v®—®----es®®-- tee®®®--®--mmm-------------s®®-
1
DISCOVER THE BENEFITS-SKIP THE CLUTTER AND SAVE THE PAPER.WITH OUR CONVENIENT PAPERLESS BILLING YOU RECEIVE YOUR BILL ONLINE AND GET AN 1
1 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 1
1 THE INFORMATION ASSOCIATED WITH YOUR UTILITY ACCOUNT.IT'S A SUSTAINABLE,EARTH-FRIENDLY CHOICE.SIGN UP AT 1
1 HTTPS://TIGARD.MERCHANTTRANSACT.COM 1
®—®®®®®®--r®®��®®®®®®®®®®®®®m®®®®®®®—®®®®®®®®®®®®®®®®®®®-
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.
m City of Tigard I UTILITY BILLING
13125 SW Hall Blvd.
Tigard,OR 97223 DUE DATE: August 24, 2016
TOTAL DUE: $144.74
ADDRESS SERVICE REQUESTED Service Address: 9260 SW MILLEN DR
Customer Number: 027576-000
2044 1 AV 0.376 51310 02071 0001:0001
Make check payable to:City of Tigard.
Iltl�lllt�llnlllllllt�lltl�lillrlltlltlnlll�lllfll�l�ll�tllllll 503-718-2460 www.tigard-or.gov
AMBER&VINCE CLARK
9260 SW MILLEN DR r. It Itl 11 III !1111 .111111111 I II I I III 1111 I 1111
TIGARD OR 97224-5570
CITY OF TIGARD
P.O. BOX 3129
PORTLAND, OR 97208-3129
101027576000000000000144742
OREGON
PASSENGER REGISTRATION
PLATE NUMBER TITLE NUMBER PROCESS DATE IRATION DATE FUELTYPE EQUIPMENT NO.
ZWY518 1 16005299421 010516 DEC 09, 17 GASOLINE
YEAR MAKESTYLE I MODEL VEHICLE IDENTIFICATION NUMBER WEIGHT/LENGTH
20001 PLYM 4D NEO 1P3ES46C8YD753174
TITLE BRANDS - NONE ODOMETER READING ODOMETER DATE
OWNER/ 194, 0001 12/11/15
LESSEE ODOMETER MESSAGE
CLARK, VINCE W
CLARK, AMBER LYNN
9260 SW MILLEN DR
TIGARD OR 97224 COUNTY OF COUNTY OF
RESIDENCE USE
NEW WASHINGTON
ADDRESS
OREGON
PASSENGER REGISTRATION
PLATE NUMBER TITLE NUMBER PROCESS DATE EXPIRATION DATE FUELTYPE EQUIPMENT NO.
;E 1-1219-10105 I t I
803GZY 080714 UL 03r 16 FLEXFUEL
YEAR MAKE STYLE I MODEL VEHICLE IDENTIFICATION NUMBER WEIGHT/LENGTH
I
2008 CHEV UT C15 lGNFKl63-l8Rl(-.-5216O
TITLE BRANDS - NONE ODOMETER READING IODOMETER DATE
OWNER/ 123, 609 07/02/14
LESSEE ODOMETER MESSAGE
CLARK, -AMBER LYNIN
CLARKr VINCE W
9260 SW MILLEN DR
TIGARD OR 97224 COUNTY OF COUNTY OF
RESIDENCE USE
NEW WASHINGTON
ADDRESS
OREGON 073-1
PASSENGER REGISTRATION 31
PLATE NUMBER TITLE NUMBER PROCESS DATE I EXPIRATION DATE FUEL TYPE EQUIPMENT NO.
1
783EPV 1004713018 lIZ3115 FEB 05:201.8MESEL
YEAR MAKE STYLE10MODEL VEHICLE IDENTIFICATION NUMBER WEIGHT/LENGTH
2007 CHEV FJj
SLV lGCHKZ3D87F185039
TITLE BRANDS - NONE ODOMETER READING IODOMETER DATE
OWNER/ 103156 01/15/10
LESSEE ODOMETER MESSAGE
CLARK, MINCE W
CLARK, AMBER LYNN 37560A�
9260 SW MILLEN DR COUNTY OF COUNTY OF
TIGARD OR 97224 RESIDENCE USE
NEW WASHINGTON
ADDRESS