Skip to Main Content View Text-Only

Environmental Services

working for clean rivers

Phone: 503-823-7740

Fax: 503-823-6995

1120 SW 5th Avenue, Room 1000, Portland, OR 97204

Please Read Before Submitting this Form

In order to permit the Bureau of Environmental Services to proceed with design and construction of the Hollywood-Grant Park Sewer Project, the undersigned hereby grants to the City of Portland, its employees, agents or contractor, the right to enter upon the real property listed below for the purpose of conducting the following activities:

  • Survey of existing sewer main on private property
  • Physical site visit for evaluation of manhole and cleanouts
  • Possible installation of cleanout on public sewer or lateral connection
  • Possible excavation for public sewer line repair

It is understood that all work on the Property shall be in accordance with the approved Hollywood-Grant Park Sewer Project plans and in compliance with the applicable general and special specifications dealing with design and construction of a sewer project on private property.

This Permit of Entry is subject to the following terms and conditions:

  • Paint marks and stakes may be posted; please leave in place for future site inspection.

  • Grantee will endeavor to minimize impacts to existing structures and surfaces.

  • Grantee will restore the easement area to a condition that, in the judgment of Grantee, is as good as the condition that existed before the work began.

  • Grantee is authorized to conduct the activities outlined above with proper notification being given to the grantor of the work.

  • Grantee shall coordinate its activities with Grantor to avoid unreasonable interference or disturbance.

It is further understood that this Permit of Entry will in no way jeopardize the undersigned’s rights as Grantor, or in any legal proceedings that may arise from the Grantee’s acquisition of easements through, under and across the Property.

It is understood and agreed that this right and license shall be effective beginning on the date signed and continue until project completion set within the construction contract.

Grantor hereby represents and warrants that it is the owner of the real property described below or is otherwise authorized to grant this permit.


Hollywood-Grant Park Sewer Project Permit of Entry
*
*
*
*
*
*
*
*
If you have any questions or concerns please contact Joe Annett at 503-823-2934 or joseph.annett@portlandoregon.gov
* Required Field