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Environmental Services

working for clean rivers

Phone: 503-823-7740

Fax: 503-823-6995

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

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Please Read Before Submitting this Form

In order to permit the Bureau of Environmental Services to proceed with design and construction of the Humboldt Sewer Repair 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 branch connections on private property
  • Physical site visit for evaluation of sewer branch connections and cleanouts
  • Possible crack monitoring of structures, walls, and/or fences on private property
  • Possible settlement monitoring of structures on private property
  • Possible installation of cleanout on public sewer or lateral connection
  • Possible excavation for public sewer line and sewer branch connection repairs
  • Possible set up for and lining process of existing sewer main and lateral connection

It is understood that all work on the Property shall be in accordance with the approved Humboldt Sewer Repair 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, survey 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 (at least 5 days in advance) 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.


Humboldt Sewer Project Permit of Entry
If you have any questions or concerns please contact Rhetta Drennan at 503-823-6006 or
* Required Field