9530 SW Millen Dr GP- or3� ai4�-� � 5
Tigard High School Area Parking Permit Application
Permit Period: September 2016—june 2018
1. Applicantname:
Address: �5-1 G'
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. CU
Each household will receive 1 guest-parkingJ: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
vs er.�ao
Quick Reference Information
NW Natural
Account Number 2883895-1 www.nwnatural•com
Bill Date 7/13/2016 Customer Statement For Service At:
Bill Inquiries 800-422-4012 MARK J DOBSON
9530 SW Millen Dr
Current Charges Due 7/29/2016 Portland, OR 97224-6509
AMOUNT DUE $20.45
USAGE SUMMARY NW NATURAL
ACCOUNT SUMMARY
Meter 485039 Previous Balance $6 . 2 5 CR
�.-l?ea� 7 :� �/la/i-6 Payment(s)Received . 00
Actual Read - 7568 6/13/16
Units of gas 17 30 days Subtotal Balance Forward $6 . 2 5 CR
Billing Factor x 1.086
Therms 18.5 Current Charges
Monthly Service Charge Rate 02R 8 .00
Gas Usage 18.5 @ .93513 17 . 30
2%City Franchise Fee . 51
Public Purpose Charge . 89
Subtotal Current Charges $26 . 70 b4L
Now Balance ..f f. 7
$20 . 45
A late charge of 1.8016 with a minimum of$3.00 Wray
assessed on past due balance of$50.00 or more.
You are participating in the WARM program,which adjusts
bills if weather between Dec.and midLMay is colder or warmer
LOCAL DAYS IN AVO than nofmai.
BILLING AVG DAILY BILLING THERMS
PERIOD TEMP PERIOD THERMS PER DAY
JUL 16 6.5.2 30 1s .6
JUL 15 WA WA WA WA
1.0
D
8
W
d .6
� w
D 4
W-
F .2 You are enrolled in WARM,the billing program designed to smooth out
y impacts of weather variances for those who heat with gas during the
< Deo-May heating season.if you would like to opt out of WARM,visit
15
JASON O J F M A M J J16 clrmatural.com or call 800-422-4012 by Sept.30.
PASSENGER REGISTRATION CARD
LATE NUMBER TITLE NUMBER FUEL TYPE FARM 10 NO. NEW EXPIRATION DATE
WWV003 11409074526 GASOLINE APR 26, 2017
YEAR MAKE STYLE MODEL VEHICLE IDENTIFICATION NUMBER HVUT DATE
1999 IACUR 14D L 19UUA5647XA031516 FEE
EQUIPMENT NO. EIGHTlIENGTH TITLE BRANDS
- NONE - $86.00
ODOMETER READING ODOMETER DATE ODOMETER MESSAGE
,p'40R V
• 2
*DOBSON, MARK JAMES
11466 SW COLE LN COUNTY OF RESIDENCE COUNTY OF USE
TIGARD OR 97224-3776 WASHINGTON
NEW ADDRESS(HOUSE NUMBER,STREET,CITY,STATE,ZIP CODE) A`IDbI2P15945
NEW PLATE NUMBER " $jJCKM
65 393
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