HomeMy WebLinkAboutWWP2701901(22) S-389 1985 Sewer Trunk Replacement Claims
BEGINNING
OF FILE
Sewe� �� unk
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I N T E R 0 F F I C F Y E Y 0
TO:
ng DATE: Auguste, 1985
FROM: Jane Mauch
SUBJECT: CL 35-85 - Claim for damages in an undetermined amount filed by Gerry L. Cater
for flooding of his basement due to broken water main at Tobin and
Logan Streets (8 05 85)
Attached is a copy of the Claim for Damages form on the referenced file. Please forward
a departmental report to my attention which I will serd on the the City Attorney and our
insurance service. Mark Hennessy has talked with, Tri-State Construction and they will be
contacting Mr. Galer. Please let me know if we have a bond or hold harmless with Tri-State.
Thank you.
ccV Dick Houghton 0,,/'4.r', �..,
r ,
-„ _ - CLAIM FOR DAMAGES Cm OF1Dr"
City of Renton I AUG 6 im
Q an arms wo (�
NOTE: PLEASE READ ENTIRE CLAIM FORM BEFORE FILLING IN. ) II
R.C.W. 3 .31.030, spec.ties the requirements claimant has to follow in king
claim agaira the City. --
NAME OF CLAIMANT:
(or Business Namej Last
er/ irsC Middle
CLAIMANT RESIDES AT:`j/,y .J. //,%{j�/;,) j. 'T A_ � t 14 Phone J;'l -/IS,J
refs City and ate
CLAIMANT'S said injuries and/or damages occurred on the r) day of 14,
19 /'_, at approximately o'clock am / pm.
DESCRIBE in detail how damage or injury occurred. Give full details, including what defect
caused the damage or injury. (t ,,C)Wile It j' �:: y:y:. + "> nn) _• 7EfEET
L1 T' (t,ZA_i r& e F %C r, /Ll� / ,1"4,f Nf_-- C.)A Tom' /Q
WHERE did damage or injury occur? Descri Le fully, naming streets, indicating pla„G'ce of
accid^nt, ' .e., North, South, IF or West TAfl�i'�Ec Tidal n 7 , A1
/y -d 4 Fi //; i Z. - 1'e—"d !/F 1, . %06 eL-c 7• A'Arc rni
WHAT particular ACT or OMISSION on the part of City employees do you Claim caused the
injury or damage:
WHAT DAMAGE OR INJURIES do you claim resulted? Give full extent of injuries or damage
claimed. Give the sum you claim on account of each item of injury or damage. Attach
es imate of repair or medical report, if available.
u L G L��r.n_. 7 er. r J'w" 4 L-/.'
Date Items/q To Whom Pa I Amount
�, S
S
S
S
TO"rAL amount of damages claimed: & t X/L'L)ee vj
GIVEN at King County, Washington, this day of 19
I hereby declare that the foregoing statements and information aje true and correct
to the best of my knowledge and belief, /
c A
SUBSCRIBED AND SWORN to before me this i<- Itz _ day of ., � 19J';—
Notary rn an t e rate oFWasWas r� gtoo,
residing at
No action can be maintained against the City for any claims for damages until the same
xll.�••e�= taHtr' ..es�aaar�.a�wraatwarsaareaawd
` 70' J,e.A-
I N T E R O F F I C E M E M O
TO: Bob Bergstrom, Engineering DATE: August 8, 1985
FROM: Jane Mauch
SUBJECT: CL 35-85 Claim for damage; in as undetermined amount filed by Gerry L. Galer
for flooding of his basement due to broken water main at Tobin acd
Logan Streets (805'85)
Attached is a copy of the Claim for Damages form on the referenced file. Please forward
a departmental report to my attention whirh I will send on the the City Attor,iey and our
insurance service. Mark Hennessy has talgp,0i..�ith Tri-State Construction and they will be
contacting "a r. Galer, Please I
Thank you. �t,.meicFp�if w� ave a bond or hold harmless with Tri State.
+
Jam.
cc: Dick Houghton
CLAIM FOR DAMAGES CITY ^�
flDN
City of Renton Ay` 6 1M
'UI tnynAnalma
NOTE: PLEASE READ ENTIRE CLAIM FORM BEFORE FILLING IN.
A-C-V. , spa[ITIOS the requ rements c aimant has to follow liking
claim against the City.
,/� /y /
NAME OF CLAIMANT: (TfJL ELa (.T
(or Business�a 'Twe --Cast—,/ ,n st A'iddTe
CLAIMANT RESIDES AT:.J�j� ..a. !/g.Q S%7 AA!TA/il.,, t �r4�r4 .Phone
ress �City one l act a
CLAIMANT'S said injuries and/or damages occurred on the j eay of
19'T5L, at approximately o'clock am / pm,
DESCRIBE in detail haw damage or Injury occurred. Give full details, includi? what defect
caused the damage or injury. (t ntlrffAr Tn I� Le;L.0/,"rl z, nn) IQEF?"
E1.T 0 A'AJACIC OF ! r, IL! -I- / ,1i4,fI SCY.7ii A- l„NTAP
WHERE did damage or injury occur? Describe fully, naming streets, indicating place of
accident, i.e., North, South, East, or West. £A7z-i'.SEc7ieiU n �nl,'.%U
WHAT particular ACT or OMISSION on the part of City employees do you claim caused the
injury or damage:
WHAT DAMAGE OR INJURIES do you claim resulted? Give full extent of injuries or damage
claimed. Give the sum you claim on account of each item of injury or damage. Attach
estimate of repair or medical report, if available.
F.,L[ ::I
IA. A' VA)C L-
Hh' 1�,C fi'eEti /, c'E
Date Item To Whom Paid Amount
$
5
s
S
TOTAL amount of damages claimed: L2 yY&,r 11'il
GIVEN at King County, Washington, this day of 19
I hereby declare that the foregoing statements arA,''information are true and correct
to the best of my knowledge and belief,
SUBSCRIBED AND SWORN to before me this _ day of -t 19 2
Notary in and r9r the Scats of Was�ii ngton,
residing at �"�, z
No action can be maintained against the City for any claims for damages until the same
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FILE ^^E � 98s
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S- 389