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Dosch, Jerald R�C�I�IED AUG 0 4 2014 NOTICE OF CLAIM FORM to the City of Saint Paul, l�l��i�s�a��K Minnesota State Statute 466.05 states thnt"...every pe�•son...who clainas damages from nny�nunicipality...shctll cause to be presentecl to the governing body of the�nunicipalih�witl2in 180 days after the alleged ln,ss nr injury is discovered a notice stating dTe time,p[aee,and efrcums�ances thereof,and the amount of compensation or other relief demanded." Please complete this form in its entirety by clearly typing or printing your answer to each question. If more space is needed,attach additional sheets. Please note that you will not be contacted by telephone to clarify answers,so provide as much information as necessary to explain your claim,and the amount of compensation being requested. You will receive a written acknowledgement once your form is received. The process can take up to ten weeks or longer depending on the nafure of your claim. This form must be signed,and both pages completed. If something does not apply,write`N/A'. SEND COMPLETED FORM AND OTHER DOCUMENTS TO: CITY CLERK, 15 WEST KELLOGG BLVD, 310 CITY HALL, SAINT PAUL, MN 55102 First Name ����`� Middle nitial � Last Name ���� Company or Business Name /" Are You an Insurance Company? Yes l No If Yes, Claim Number? /� � � Street Address l�O 17/l� �� City S7�• ��1 State ,/ �`�V Zip Code ��`�� Daytime Phone��� )�ZS �'/3 Cell Phone�S�) /2S 7�"py3 Evening Telephone�� )�r ���� Date of Accident/Injury ar Date Discovered �� �� � Time���pm Please state, in detail, what occurred(happened), and why you are submitting a claim. Please indicate why or how you feel the City of Sai}�t Paul or its employees are involved and/or responsible for our damages. SPA �t�.� .���Zt O r7�'. `i�� �� /� .� � o .�� � �. . .a Ge : �� d v : G o � .�, ���- u .�1�i J� i�r► /'��t) —Q�. Go w7�2�t7"'e r– ,1'a i� �"/�is �e�.�.�s� e�o -�.,� ��� �.-aof/ ti�►/�-J� .9yr I'hQtti�ve tl,,, i� N�,.,��d.--- •�� /.�ak� Ac�� cs.✓Yl'��� `�'�,o�..sewd d��/etrs �e �e /.osf Please check the box(es) that most closely represent the reason for completing this form: ❑ My vehicie was damaged in an accident ❑ My vehicle was damaged during a tow ❑ My vehicle was damaged by a pothole or condition of the street ❑ My vehicle was damaged by a plow ❑ My vehicle was wrongfully towed and/or ticketed ` ` ❑ I was injured on City property �Other type of property damage–please specify S��l�w f,i� �Q'�ai�%o.� t..J4�/ ❑ Other type of injury–please specify � In order to process your claim you need to include copies of all applicable documents. For the claims types listed below,please be sure ro include the documents indicated or it will delay the handling of your claim. Documents WILL NOT be returned and become the property of the City. You are encouraged to keep a copy for yourself before submitting your claim form. O Property damage claims to a vehicle: two estimates for the repairs to your vehicle if the damage exceeds $500.00; or the actual bills and/or receipts for the repairs O Towing claims: legible copies of any ticket issued and a copy of the impound lot receipt • Other property damage claims: two repair est'mates if the damage exceeds $500.00; or the actual bills and/or receipts for the repairs;detailed list of da�aged items O Injury claims: medical bills,receipts ' • Photographs are always welcome to document and support your claim but will not be returned. Page 1 of 2–Please complete and return both pages of Claim Form REC�l�IED AUG 0 4 2014 NOTICE OF CLAIM FORM to the City of Saint Pau1, 1�1��i�s�a�RK Minnesotu Stute Stutute 466.05 states tliut "...every person...who claims dmnnges Jrom any municipulity...shull cause to be presented to the governing bodv of die n2unicipalih�widzin 180 days after the alleged loss nr injury i.r discovered a notice stating t/ie time,place,and crrcum.r�nnces thereqf,and the nmount nf cnmpensation or ather relief demanded." Please complete this form in its entirety by clearly typing or printing your answer to each question. If more space is needed,attach additionai sheets. Please note that you will not be contacted by telephone to clarify answers,so provide as much information as necessary to explain your claim,and the amount of compensation being requested. You will receive a written acknowledgement once your form is received. The process can take up to ten weeks or longer depending on the nature of your claim. This form must be signed,and both pages completed. If something does not apply,write`N/A'. SEND COMPLETED FORM AND OTHER DOCUMENTS TO: CITY CLERK, 15 WEST KELLOGG BLVD, 310 CITY HALL, SAINT PAUL, MN 55102 First Name ����`� Middle nitial � Last Name ���� Company or Business Name /" Are You an Insurance Company? Yes/No If Yes, Claim Number? /v /� Street Address l'O 17�1� �� Cit �� ��/ State /�`� Zip Code ���7�' Y Daytime Phone ��� )9ZS ��3 Cell Phone�S� ) /2r�Evening Telephone�� )�r �7��� Date of Accident/Injury or Date Discovered O2 Z� � Time • �`� m pm Please state,in detail, what occurred(happened), and why you are submitting a claim. Please indicate why or how you feel the City of Sai t Paul or its employees are involved and/or responsible for our damages. SPA �al .���Zt �rl�'. Ii��" .1� /� � p ;r. � Ge : �a a. e : G o 7�i�i i� �7/�t Lt �L.i�� i�n �9�Z� G1tiZ Go w7�r'4 t�as�' ,!'e[i e( � �Q nw s'7� dv -�iCt bs r...� / �,•��..,� .�� rha�c,l.� cG„ .'3 �•M�,r�d. ��- r,,.�ok t�( a�l��s�,rrx� -�►e�..s e�d d�,��e►rs -�e � r.o�1� Please check the box(es)that most closely represent the reason for completing this form: ❑ My vehicle was damaged in an accident ❑ My vehicle was damaged during a tow ❑ My vehicle was damaged by a pothole or condition of khe street ❑ My vehicle was damaged by a plow ❑ My vehicle was wrongfully towed and/or ticketed ❑ I was injured on City property �COther type of property damage—please specify Sqow w i�' e� i ; ❑ Other type of injury—please specify In order to process your claim you need to include copies of all applicable documents. For the claims types listed below, please be sure to include the documents indicated or it will delay the handling of your claim. Documents WILL NOT be returned and become the property of the City. You are encouraged to keep a copy for yourself before submitting your claim form. O Property damage claims to a vehicle: two estimates for the repairs to your vehicle if the damage exceeds $500.00; or the actual bills and/or receipts for the repairs O Towing claims: legible copies of any ticket issued and a copy of the impound lot receipt • Other property damage claims: two repair estir�nates if the damage exceeds $500.00; or the actual bills and/or receipts for the repairs; detailed list of dariiaged items O Injury claims: medical bills,receipts • Photographs are always welcome to document and support your claim but will not be returned. Page 1 of 2—Please complete and return both pages of Claim Form Failure to complete and return both pages will result in delay in the handling of your claim. All Claims—nlease complete this section Were there witnesses to the incident? Yes No Unknown (circle) Provide their names, addresses and telephone numbers: Were the police or law enforcement called? �� No Unknown (circle) If yes, what department or agency? Sfi_ �s�,I ��- Case#or report# Where did the accident or injury take place? Provide street address,cross street, intersection,name of park or facility, closest landmark,etc. Please be as detailed as possible. If necessary, attach a diagram.T ��%t¢- ��"� S�. Q'� M�/ �1�3� Please indicate the amo t you are seeking in compensation or what you would like the City to do to resolve this claim to your satisfaction. �•� � 1�1G o i '"� 3�sbn ✓'e Vehicle Claims—please complete this section �check box if this section does not applv Your Vehicle: Year Make Model License Plate Number State Color Registered Owner Driver of Vehicle Area Damaged City Vehicle: Year Make Model License Plate Number State Color Driver of Vehicle(City Employee's Name) Area Damaged In.iurv Claims—please complete this section �check box if this section does not applv How were you injured? What part(s)of your body were injured? Have you sought medical treatment? Yes No Planning to Seek Treatment(circle) When did you receive treatment? (provide date(s)) Name of Medical Provider(s): Address Telephone Did you miss work as a result of your injury? Yes No When did you miss work? (provide date(s)) Name of your Employer: Address Telephone �Check here if you are attaching more pages to this claim form. Number of additional pages �Z By signing this form,you are stating that all information you have provided is true and correct to the best of your knowledge. Unsigned forms will not be processed. Submitting a false claim can result in prosecution. Date form was completed �� 3� 24/ Print the Name of the Person who Completed this Form: ��cl �� Signature of Person Making the Claim: Revised February 2011 , Accident Report P e 1 of 1 � � � ��� � � I 19034196 f� (' � I M+MGAM OW�nO. K1CLEi MLLiD IYM � � N' 'N c�l 00 �0 � ,2 21 2014 �ri 1139 � nourtsvs+EU r�r,�noaemcerw� � � �q,�,� � 10 Alice � e w ❑wm�rrwiero"� ai �_.�_ �rt es �wa� � � � COVMiYMO � MHlY /OBIEIIfE.OMt iIOV�FM MOI/IF/.Y11Yif,COw1Y�.ORli117YRt .. 62 �,`: St. Paul +�. 10 Ohio � r.cm.� vwmn rn�siuca�w�+cx�� sr��t a.w an,.ns oorna+ aww�ucouaw.ea.t n.x aw annnn � '� 61 O1 h468097248918 MN B 01 35 � � .�c,oa: «,�c�me*.rwne.u...� wicas.w,w rwi[nw.trco�e.usn n„tor.aN nc,oe: 61 TIMOTHY NATHAN TESSER O1 11 77 O1 INMII t0 W MOL . OII 1MFB1 96 457 Oday Circle N; 40 Alice St N.? 48 n„van an.eurz.a una.vE.n mm� O1 Maplewood 55129 651-248-6223 St Paul 55107 98 ncaw �} �ex �a.r .�r[wr wwa ucc, Mueev �t aE.,c �€�com w.r ,w..o w., uu.a wd.o � O1 Y-: M 9 U°� 04 06 05 N -Y.� �"Yt9 �98 98 98 N O1 NLN iKE OILLq lYK IOWr 111MNPQItt �YWIANCfYGIMfY qMlUY�EII KOl lYK p1U0 lYK MMW� 11UMMOIR IMM�/iClMNCE 11WI4M�01 "� 98 t�" 98 t1, p M� "g� 98 f"T 98 t3,� o"" o a++.� �,. �� � ��..� � �,. p� CITY OF ST PAUL N Jerald Jay Dosch t� -2 VlMM MDIIFSb TdKO AOOIIEq TdY[O VEMM 90 891 N DALE ST N; 40 Alice St �i 54 wh uE ur..a.�e.a .i...a owccr cm::un.r. /uuw o.ccr w�ui � 13 ST PAUL MN 55103 "tC`, 04 St Paul MN. 55107 "'� 98 98 OMGWG MMCE M006 lEM OOlpi W/F YOOQ rFM! C0.011 OM6LOC � 90 FORD COL 199 98 � OMO!!V M1fI STMO YFMiEO �O�6 ��1WW RATF� {TKC YFARp[G �WM 011.YV , O1 g18922 MN 6 � 41 4� 41 41 41 98 wu�w� ro�w�n .aon.�nw�n o�arevw�.+w � SELF INSURED i w�oo w¢r,. w.MO w�cr,o,,. .n.aeoc. w�+� w�wr wr ME nuc FACQDE!(TWVOWfDACOMMERCIALNOTORVEHICLE.lCi100LWl.ORHEAOiTARTWi , ru�G rne ' � RE�EMBER 701{OTIfY 711E STATE YA7ROL ln�Wnd untlN Mi 1M.7p MA/pAf11�. �! GIN.ERf1KVBlK'1lMlIlERt.wOIORCMfiFANME OOTIUI�EA OOIYIIU'N4iNf1EMI.�ER7.AIDTORf/NIIIiRNNf OOf1MiA � I M61EN0l0.1/WAIE56E6 � Wlf 1NMTEOI 1EY ME UIf NNM EEGT w!!V t01108►TP11N!'ORf � � I Oy� N�MN�I�Cf I�Nr�M1EM I QOIIIa ^ I V O�r �r�EI1V�R RMIIIK61 � . i O� � O� �MtlNVlf� I�./IIMiFA � . QCT�91 /� ��. �il orMmo/on�FAWw�aFDana4Attw�oo[aplv��wlvMwDlDrRaP9fIrAM6oRruaaw�MMYl61(bl MM�o[DMO/61lY�YBiOwnUMMq � , ACCiVV ����. OIVIfE 13 __ .__ _.__..__... ._.__. .._.. --- . . 98 I �c�ws 03 Veh.#1 ( City Plow truck) Nas plowing snov in the ..._.._......_ __. _. .. .. �TM area of Alice St/Ohio St. Due�to the slippery �o road conditin�Lha..plow_.tru.ck..flsh-tail,._calZ_ed. . 98 O1 backward and hit a private retaining wall in °M'ROOE '�� -5tont of 40 Alice St. Several- cylinder blocks, ---- M� N' ° ° -°' '- fe11 out of the wall. n.er ro��E O1 ,v.ewwe - � .. __. __._._.. _._......_._._..__ � DziverYl and owner of the retaining wall advised �'� 98 i that they photographed the damage to the wall � ' ! �iwa � alLeady. ,. . wun.n� � � ,.—... �� No-damaged to the plow-tsuck.-...- -.-- - 04 ....__.. . ,..._._ wF.n�9�� �,,,, _ __ _.. .. ___.. _ _ .____ �9 0 8 ....., _ „�„ .. _ . . _._. . __ _ .,... b,�M O 1 03 _ ____ _ ...._ _ ____ -- - � • _ _ _.._ _ . _ � 5 . . . ..... .. ... . . . OIMMW rouw� � . .. ..._._. _ _..... ..._ ._.._.............. __.._..._ I 02 __ 90 ��»,.���. � ..,�.,.,� �.�� ��.. Patrol Lue Vang 419 02�"� St Paul PD G p s�... Do,�.,� t. ,(�' i� http://dvslesupport.org/dvsinfo/accidentrecords_2008/Includes_LE/PrintReportIndiv LE.a... 2/21/2014 7la6/��:4__'- • , Macalester College Mail-Retaing Wall � M����.��Fr�.�: Retaing Wall Brad Coleman, Precision Hardscapes<bcoleman@precisionhardscapesmn.com> Mon, Mar 24, 2014 at 7:58 AM To: Jerald Dosch <dosch@macalester.edu> For us to have the wall match we would need to repiace the damaged wall w/ a new wall. Brad Coleman Project Manager, Precision Hardscapes � Bid #6 40 Alice CT.pdf 594K https://mai I.g oog le.com/mai i/u/Ol?ui=2&i k=8927384fac&�i e�r pt&q=bcol eman%40precisionhardscapesmn.com&q s=true&search=q uery&msg=144f42b87db15c... 1/1 Pro osal � � zt p __ � � _ - �:�:_� _� -- --= _- .��,. Precfsion Hardscapes, LLC � ! � � ��, 1500 Olympic Street ' " Braham,MN 55006 (651)368-3168 To Jerald Dosch � � � Project Name Jeralds Wall Project Address 40 Alice CT St.Paul MN '���� Item Description: • Remove 52'-0"and dispose of existing retaining wall that runs along sidewalk/driveway. � ; • Install 52'-0" new Diamond pro retaining wall w/filter fabric and drainage rock in the same location and height � of old retaining wall. . � Precision Hardscapes, LLC proposes to furnish material and labor in accordance with the above specifications for the sum of: Dollars$ 7000.00 PAYMENT TO BE MADE AS FOLLOWS: Full Payment to be made within 30 days of completion No retention to be withheld Proposal Includes: All removal and clean up necessary to complete project. Page 1 of 2 NO: 000006 Date:3/12/2014 Open as of:3/21/2014 Exclusions: • All plantings and grass restoration are not part of this proposal. Assumptions. Landscaping by others. Precision Hardscapes Proposal is based on ten-hour days. Access to site and the ability to get material and equipment to work area to be unrestricted. All cutting to be dry. ACCEPTANCE OF PROPOSAL: CONFIRMED: The above prices,specifications ond conditions ore sotisfactory and ore hereby accepted. pCeCISIOII IIaCUSCa�IeS, LLC Precision Hardscapes,LLC is authorized to do the work as specified. Payment will be made as outlined above. Authorized Buyer: Signature Signature: Date: Date of Acceptance: Note:This proposa/may be withdrawn,by For any questions about above information, please call. provider,if nor accepted within 30 days of creation. Project Manager: Brad Coleman 651-368-3168 Project Manager: 13rad S. Colew�an 651-368-3168 Page 2 of 2 NO: 000005 Date: 3/12/2014 Open as of: 3/21/2014 7:16/2014 Macalester College Mail-retaining wall quote � �����.�s-t-�.� retaining wall quote Staniey Genadek <energy4@mac.com> � Fri, Mar 28, 2014 at 4:55 PM To: Jerald Dosch <dosch@macalester.edu> I did look at the wall. The only way to rebuild your wall and do it the right way is to remove the large tree in your front yard. Otherwise if I rebuild the wall with that tree in place it will wid any warranty. No matter who builds the wall some of the roots of that tree will get damaged to get the proper amount of drainage aggregate in place. Any and All modular block retaining walls take a minimum of 12" of drainage aggregate behind the back of the block to be designed and installed correctly. I don't have clearance to install your wall and do it the right way. I will be upfront with you.-We only have 2 options. Option #1 remo� the tree and build the wall the right way. Option#2 leave the tree and build the wall without a warranty. [Quoted text hidden] � l��.aR- n�� -�'� 2� �7'�c� � 74`e� � � . J ���`7wC4 w�4`�� Q4� V'������/"I �,,,,,,�17`— �(�s � �f�� �� ���1't � 7/4 f.o s�� � https://mai I.g oog I e.corr✓mai I/u/0/?ui=2&i Ir 8927384fac&�i ev�r-pt&q=wal I%20q uote&q s=true&search=q uery&msg=1450ab1233c5cbf6&si ml=1450ab1233c5cbf6 1/1 1 GE NAD E K c�` LANDSCAPING AND EXCAVATING INC. Phone#612-369-4698 Fax# 651-552-2066 RETAINING WALLS DEMOLITION EXCAVATION Incorporating courtesy, dependability and integrity into everything we do. 3-31-2014 Work to be performed:Retaining Walls Customer: Jerald Dosch, � Site location: St.Paul Project description: Remove the existing wall and install a new boulder or modular block retaining wall. Project total $8 900 � Proposal includes: *Boulders,or modular block with installation *Excavation and grading work. Proposal does not include: *Handling of Hazardous Materials,permit fees,surveying,dewatering,soil conection. *Finish landscape plantings,plantings,sod or seed,sprinkler repair,fence installation. Noticc of Prc-Licn This notice is to advise you of your rights under the Minnesota Law in connection with the improvement to your properry. Any person or company supplying labor or materials for this improvement may file a lien against your property if that person or company has not been paid for the contributions. Under Minnesota Law,you have the right to pay persons who supplied labor or materials for this improvement directly and deduct this amount from our contract price or withhold the amounts due thcm from us until 120 days after completion of the improvement unless we give you a lien waiver signed by persons who supplied any labor or materials for the improvement and who gave you a timely notice. This proposal for the retaining wall is based on a price per square foot for the install dependent on actual quantity placed above and below grade.$100 to schedule the project. If you have any questions please call Stan at 612-369-4698. Genadek Landscaping and Excavating Inc. 716 Third Ave., Mendota Heights,MN 55118 Authorized By: 7/16/2014 Dosch wall and plow,40 Alice Street,St.Paul 55107.jpg -_ „ a � � . _�, - �a "�- . �� �°�` � � ���'� '`�? �;�'� , , � � � rx � , � , -�, --� � � � „� � � i�fi � ":' � ,; r � 'u� �,�h�r �� � �� ,�' 5 � ��� � - �` �� '� `��"'�'r ; �`��� ` '4 �! �`� � �-� � *"• ���^ ����-�y��� ,����� �} t �'0. � �, ��FN�.�; � - " ..,.. �1 x�:*� t�?�°"c Y�'�d�t `t� k ���"x �'"` r _ � � �' �.� .� � ��i ' ��\.t�i? � s� �� � .� '� ., � , ' �"�'��. �•,� � � � �. a. ,y,�Ic� �;V�:: ,E�x�-d�,� �� s�,��. �, '� � - . , ' �*�"��4,�'�s 21.t � ���,��#`;ff�/ "--s_��� � �x�` _ � � �� � � �i � +.� }a��� � �Y�'�� �. �� �y �, a�� ! �� �, ,, � ��, '� �i �w- �• �^ �"` "�', � ;• 1�-,a � �� '� s� �t^"" �v�si ���i� ni � �.. y���#y,✓:+t �� �£ 4a '� t�:. f t . /$' < y, o-" �„: .; - ' + t" d� S ��, "°l. � � �o- p n. 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'.r . �_ . . �. . _ �,',�,:�n ,r� �r,,,�� � t-�� o��lti.�:'E 4„�+ _ � ' ,�� . , �,__ ` . _ - � _.. ,.� . ._. �.'- �` ''� , .6;Y.��'= y? ,�,. . .��� �W� "� � �`� � A� �-� �'�„Y� L� .e � " .-..r �.:`' �. � . , . . _ � � w� � . d ._ * . . �`� � > x. �r �"' ° �, ... . y�, �, _ , .< . � � re�� ` � �.„. ,� _ ,_ � � :s, ` ,.�>� � _ u ,4 ,� - � � _ �� a,. � �_�z , . . =a � �- _ � ��e,� ��: .a _ '- � � �� �a � �' ,�. ;, � F � � � �,� ��� r � .. . _ _ ; < , v , � P�, a �§ z https:!/mai I.g oog le.corr�mai I/u/0/?ui=2#search/city+wal I+stan/144b7851 abOb1 fff"?proj ector=1 1/1 ' fi ,< ' 1 * �� i r i + '� ' �+� �- x r� ,,• ' •�^¢'`�.� : ���,,.� � .+` � t�` '��+±w.,�... ° +���. � . � �, �` � ��_. \ � t� � �:� �k� � �� �� �a "�� � ..� 2�..F'- ��S +� ,� ° �`�`` �. �1. � s „��. ,��.-`r` �, � �� a p \��....` �+`.. _� �., ���,.:�����f��if+'I�i �� cx � ' � ��, �.`. ,.�:., t .. � :i �, K �. � ��`� ��, 44 -�, � �:y_ . � � �, �� � , � t; • . � . �;. 3 t � ' Page � of 5 Saint Paul Police Department ORIGINAL OFFENSE / INCIDENT REPORT Complaint Number Reference CN Date and Time of Report 14034196 02/21/2014 13:45:00 Primary offense: TRAFFIC ACCIDENT-PROPERTY DAMAGE ACCIDENT Primary Reporting O�cer.• VBng, Lue Name of location/business: Primary squad: 297 Location of incident:ALICE CT&OHIO Secondary reporting o�cer.• ST PAUL, MN 55107 Approver. Grahek, Jon �isrricr: Central Date&time ofoccurrence: 02/21/2014 11:39:00 to Site: 02/21/2014 11:39:00 Arrest made: Secondary offense: Police Officer Assaulted or Injured: Police O�cer Assisted Suicide: Crime Scene Processed: OFFENSE DETAILS TRAFFIC ACCIDENT-PROPERTY DAMAGE ACCIDENT Attempt Only: Appears to be Gang Related: Crime Scene Method 8 Point of Entry Type: public domain Force used: Hid Inside: oescription: Highway/streeUroad/alley Point of entry: Method: NAMES Driver Tesser, Timothy Nathan 457 ODAY CR MAPLEWOOD, MN 551119 Nicknames or A/iases ', Nick Name: �i i Alias: AKA First Name: AKA Last Name: Details sex: Male Race: White DOe: 01/11/1977 ResidentStatus: Hispanic: Age: 37 from to � Phones Home: Ce�l: Contact: 651-248-6223 Work.• Fax: Pager. SP0000025COF8EFA • ' Page 2 of 5 Saint Paul Police Department ORIGINAL OFFENSE / INCIDENT REPORT Complaint Number Reference CN Date and Time of Report 14034196 02/21/2014 13:45:00 Pnmary offense: TRAFFIC ACCIDENT-PROPERTY DAMAGE ACCIDENT Employment Occupation: Employer. Identificafion SSN: License or ID#: License State: Owner posch, Jerla Jay 40 ALICE ST ST PAUL, MN 55107 Nicknames or Aliases Nick Name: Alias: AKA First Name: AKA Last Name: Details sex: Male Race: White DOe: 10/13/1967 Resident Status: Hispanic: Age: 46 from to Phones Home: Ce►�:651-925-7943 Contact: Wo�: Fax: Pager: Employment Occupation: Employer. Identification SSN: License or ID#: License State: Suspect UNKNOWN Nicknames or Aliases Nick Name: Alias: AKA First Name: AKA Last Name: Details Sex: Race: DOB: Resident Status: Hispanic: Age: from to SP0000025COF8EFA • - Page 3 of 5 Saint Paul Police Department ORIGINAL OFFENSE / INCIDENT REPORT Complaint Number Reference CN Date and Time of Report 14034196 02/21/2014 13:45:00 Primary offense: TRAFFIC ACCIDENT-PROPERTY DAMAGE ACCIDENT Phones Home: Cell: Contact: Wo�: Fax: Pager.• Emp/oyment Occupation: Employer. Identification SSN: License or ID#: License State: Physical Description US: Metric: Height: to Build: Hair Length: Hair Color.• Weight: to Skin: Facia/Hair.• Hair Type: Teeth: Eye Color.� Blood Type: Offender Information Arrested: Pursuit engaged: Violated Restraining Order. DUI: Resistance encountered: Condition: Taken to health care facility: Medical re/ease obtained: SOLVABILITY FACTORS Suspect can be Identified: By� Photos Taken: Stolen Property Traceab/e: Evidence Tumed In: Property Tumed In: Related Incident: Lab Biological Analysis: Fingerprints Taken: Narcotic Analysis: Items Fingerprinted: Lab Comments: SP0000025COF8EFA • � Page 4 of 5 Saint Paul Police Department ORIGINAL OFFENSE / INCIDENT REPORT Complaint Number Reference CN Date and Time of Report 14034196 02/21/2014 13:45:00 Primary offense: TRAFFIC ACCIDENT-PROPERTY DAMAGE ACCIDENT PROPERTY ITEM#1 rype of�oss: Damaged Date of Loss: 02/21/2014 �ocation�ost: 40 AIiCe St Owner. DOSCh, Jerla Jay Date Recovered: Location Recovered: Model#.� Quantity: � Serial#: Article Type/Item: Other property / Miscellaneous items Total value: oescr�prron: Retaining wall in front of 40 Alice St was hit by a plow truck causing damage . Tumed in at: Locker ID#: La6 exams: Participants: Person Type: Name: Address: Phone: Driver Tesser, Timothy Nathan 457 ODAY CR MAPLEWOOD, MN 551119 Owner posch, Jerla Jay 40 ALICE ST ST PAUL, MN 55107 Suspect NARRATIVE On 02-21-14 at about 1139 hours Squad 297 ( L. Vang) was sent to Alice/Ohio on an accident involving a city plow truck. Dispatch advised the plow truck hit a retaining wall. ( NO ICC-1929) I arrived on scene. I spoke to the city truck plow driver (Timothy Nathan Tesser, 01-11-77, 457 Maplewood , MN. 55119, c/p:651-248-6223). Tesser advised he was on Alice St west of Ohio plowing the snow. Tesser said due to the slippery road condition the plow truck ( 918-922, 1990 Ford truck, blue in colored) fish-tail then rolled backward as he attempted to drive it s/b. Tesser said the right rear of the plow truck hit the private retaining wall that was in front of 40 Alice St as it rolled backward. I observed the retaining wall and noticed that several cement blocks had been knocked out from the wall. Tesser and the owner ( Jerald Jay Dosch, 10-13-67, 40 Alice St, c/p:651-7943) of the retaining wall advised that they photographed the damage already. The plow truck was not damaged. No further information. SP0000025COF8EFA • � Page 5 of 5 Saint Paul Police Department ORIGINAL OFFENSE / INCIDENT REPORT Complaint Number Reference CN Date and Time of Report 14034196 02/21/2014 13:45:00 Primary offense: TRAFFIC ACCIDENT-PROPERTY DAMAGE ACCIDENT PUBLIC NARRATIVE On 02-21-14 at about Officer was sent to Alice/Ohio on a APD. Vehicle struck a private retaining wall. SP0000025COF8EFA Failure to complete and return both pages will result in delay in the handling of your claim. All Claims—please complete this section Were there witnesses to the incident? Yes No Unknown (circle) Provide their names, addresses and telephone numbers: Were the police or law enforcement called? � No Unknown (circle) If yes, what department or agency? 5�.��,� �o�Zr-- � Case#or report# Where did the accident or injury take place? Provide street address,cross street, intersection,name of park or facility, closest landmark,etc. Please be as detailed as possible. If necessary, attach a diagram. �l�o �%C¢ ��ft -- - -��. �'��_ M�/ �l�`fi _ Please indicate the amo t you are seeking in compensation or what you would like the City to do to resolve this claim to your satisfaction. O.�o � (,c1G o i '"� 3i3Gn �/�e Vehicle Claims—please complete this section �check box if this section does not applv Your Vehicle: Year Make Model � License Plate Number State Color Registered Owner Driver of Vehicle Area Damaged City Vehicle: Year Make Model License Plate Number State Color Driver of Vehicle(City Employee's Name) Area Damaged Injury Claims—please comalete this section �check box if this section does not applv How were you injured? What part(s)of your body were injured? Have you sought medical treatment? Yes No Planning to Seek Treatment(circle) When did you receive treatment? (provide date(s)) Name of Medical Provider(s): Address Telephone Did you miss work as a result of your injury? Yes No When did you miss work? (provide date(s)) Name of your Employer: Address Telephone �'Check here if you are attaching more pages to this claim form. Number of additional pages �Z By signing this form,you are stating that all information you have provided is true and correct to the best of your knowledge. Unsigned forms will not be processed. Submitting a false clainz can result in prosecution. Date form was completed �'� 3� 24/ Print the Name of the Person who Completed this Form: ��cy .�!J� Signature of Person Making the Claim: � Revised February 201 I , Accident Report Page 1 of 1 ��� � � 19034196 f� � � �.+�ow�n a.wn. �cwwFS �aa�o �r w�m� �a�r[ tioNV,.a N 'N c�l 00 '00 $ 2 21 2014 �rl 1139 � wu.�svsnu r�nowai.�rw+� � o � •r io Ai��� o ; w C7.�..�m'�, �, �.� �" 8: �=°� .� CW11fYn0 � - MIHLM N@91EMf�►ONI OW1FM NWR4YmNT.001FUn.ORILIq1Ai 62 �„�. 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'uuw owoer vr.�wc 13 ST PAUL MN 55103 "tC`, 04 St Paul MN. 55107 "'� 98 98 WCIOC w�u(F 1qOg 1'EM COlpi MNQ YOOB �FNt CQ011 UMG{AC 90 FORD COL 199 98 ��� a„n. �.� ,�� ,_ ��.�e ��«�., .uh, ..� �� „e ""` 98.N O1 918922 MN 6 41 4� 41 91 91 wu�w.� raicr wueEa .aw,�wra n .ak�w...a SELF INSURED � �wr wnneo n�crw+. wv a�oot� F ACCDENT INVOLVED A COMMBtGAL MOTOR VEHItIl.tCN00LlUS.OR NEAD lT11RTllp � � rn[ � � RE�EMBER TO NOTIiY 1/1E STATE YA7ROL(n�uYW unAn M{1M.7p xW/pAH1I. . . COIMFRfiKVMYllMIMBERI.MOR1�CMfiFRMME OOTMM�ER EOI�IIfJi1LYV�U[M��6t1.NDl0�G�MFAMMF OOfM�fA PNRNRA1/wrIMEffiE6 � WT niu�na fFI ME WE NMO lECT wIFV TD1qYTRwMOR7 . . Oy,� /JAYIMCf IUINWEn � o� � O� ��EMVC[ IIIMMMq � QGT1p Z O� M!tllf�l[Y RMIViFA ,�� O� � ovmena oma o.ww�nwar�nn�wo oaaaianw n nvMao rnorurv�nnaR"rivaw aa r�areWSl aw.o�Maw+r�vniow rw wre� � .a rv rww�rnc.. oevxa 13 98 k�� __ __ _ _.._..___. ._.__. ..._.._ __.. 03 Veh.{1 ( City PloW truck) was plowing snor+ in the . . _ _ �TM acea of Alice St/Ohio St. Due to tAe slippery �� road.cnndltion_Lhe.plow,truck_flsh-tall.__[cll_Cd. . 98 O1 backward and hit a private reGaining wall in °"""O0E '�� -front of 40 Alice St. Several- cylinder blocks. -.-- M� j�` � - ' "''' '_= fell out of the wall. iv.enrrt . /�br rr7 �« _._._ __ __.__., _...._..__ � int� 98 i j DriverYl and owner of the retaining wall advised ` _. -- � A that they photographed tfie damage to the walf Ialzeady. , "f'`^'i", ,..,� . 04 �`� � No-damaged-to t_he plow tsuck...__ ..____....,_. __._.__ v.�,�na t _ __ __ _ _.._ .._ . _ 09 � _ 0 8 ....0 _ uaR .. ._ _-- . _ _ .,.. b� O1 03 _. . . ._ ._ . ..._ ____ _ . _. 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