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Aydt -- - -- _ ___ __ � � r NOTICE OF CLAIM FORM to the City of Saint Paul, Minnesota Minnesota State Statute 466.05 states that "...every person...who claims damages from any»2unicipality...shall cause to be presented to the governing body of t/ie municipality within 180 days after the alleged loss or injury is discovered a notice stati�ig the tinae,place, and circumstances thereof, arid t/ie a�nount of compensation or other relief denianded." 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 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 PAiJL, MN 55102 First Name v��Q��' Z� Middle Initial�Last Name /'�n� m...-,�,P-�•.� ,� , Company or Business Name U Are You an Insurance Company? Yes No If Yes, Claim Number? � , Street Address �� ���.�I��l.r�U r ����(,���� City ��, ���L State��/ Zip Code-<y�� Daytime Phone (�)���Cell Phone (��-��Evening Telephone U - Date of Accident/Injury or Date Discovered ��-�����_Time�_am/� Please state, in detail, what occurred(happened), and why you are submitting a claim. Please indicate why or how you feel the City of Saint Paul or its employees are involved and/or responsible for your damages. I�---�—� / � ���� L�� 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 the street ❑ My vehicle was damaged by a plow ❑ My vehicle was wrongfully towed and�'or ticketed ^-� � ❑ I was injured or�City propei-t�,� �Other type of property damage-please specify ���/�L�/ � �1 �� l A�,�L '� �`/���C D ❑ Othcr typc 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 properly damage claims: two repair estimates if the damage exceeds $500.00; or the actual bills and/or receipts for the repairs; detailed list of damaged items O Injury claims: medical bills,receipts �hotographs 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 __ _ _ _ �„ . q ,i 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 Unlrnown (circle) Provide their names, addresses and telephone numbers: Were the police or law enforcement called? Yes ` No Unlrnown (circle) If yes, what department or agency? 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 poss 1 If nece sary, attach a diagram. ����C.���,A/�/� Please indicate the amount�ou are seeking in�compensation or what you would like the City to do to resolve this claimL to your satisfaction. � � , � � — ���— — �ehicie Claims�lea�o�p� I�te�t�'nts sectio ������ ❑ check bux ii tiiis section uoes��ot aapiy 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 Iniury Claims=please com�lete this section ❑ check box if this section does not apply How were you injured? � What part(s) of your body were injured? Have'you sought medical treatment? Yes No Planning to Seek Treatment(eircle) When did you receive treatment? (provide date(s)) Naine 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�. By sig�zing this form,you are stating tlaat all informatio�z you have provided is true and correct to the best of your knowledge. Unsig�Zed for�ns will�iot be processed. Submitting a false claim ca�x result in prosecution. Date form was completed '-' ��O �' �� Print the Name of the Person who Completed this Form: ���P���.�� ���� Signature of Person Making the Claim: Revised February 201 1 �. fi � 679 CHEROKEE CLAIM o On August 1 St, 2012 the City of St. Paul began work on the sidewalk on the Morton St. side of our property 679 Cherokee Ave. During that process they unnecessarily tore down a very large portion of our retaining wall that was adjacent to the sidewalk and also severely damaged the retaining wall extending into the conjoining alley (see diagram/before and after pictures). o We were not given any prior notice of any kind that the City of St. Paul intended to destroy our private property or that they had any concerns what so ever of the stability and/or condition of the existing retaining wa11. o If there were any concern on the part of the City of St. Paul that the retaining wa11 could fall or that it was "encroaching"on the sidewalk,the work needing to be done to the adjacent sidewalk could have been postponed until we were given proper notification, even cited if necessary and then the issue could have been addressed at that time. Instead the City of St. Paul made the decision to damage our private property and to send the only notice of any kind concerning the retaining wall the day after the incident occurred. (see attached letter) o The retaining wall adjacent to the sidewalk was not encroaching on the sidewalk in a manner that made it unsafe or impassable for pedestrians. (refer to pictures #6 and#7). It was stable. It was not a public safety issue. If it was, why weren't we notified previously when the city has been out to patch/repair cracks in the sidewalks or when the crew came around and marked the sidewalks for replacement? When the streets were repaved or swept?? The City of St. Paul has been out for multiple reasons on previous occasions and the reta.ining wall was never cited. o The retaining wall that extended into the conjoining a11ey was also stable and undamaged prior to the removal by the City of St. Paul of the retaining wall that was adjacent to the sidewalk. (refer to pictures#3, #4 and#5) o The City of St. Paul could have applied other methods to remove the sidewalk that would have not done any private property damage to our retaining wall however they choose not to do so. The old sidewalk could have been"scored" prior to the removal,thus eliminating any need to remove the retaining wall along this portion. o There could have been much more care and delicacy applied to this job; however everything indicates that it was done hastily and without any concern for attempting to use any other methods other then what was the quickest; thus causing our retaining wall adjacent to the sidewalk to be needlessly torn down and our retaining wall going up the alley to be damaged as well. No concern or extra attention was given to preserving our private property what so ever. o We would appreciate your help with processing this claim ASAP to insure that further private property damage does not occur due to the fact that the earth wall that is now exposed because of the retaining wall being torn down is now unsta.ble and could fall onto the sidewalk at any time. ��� � r� a��w�� ��������s � � � „ � � � � � - �����J -; � � � �y 1 .3 � � �� � �� � � �' Z ' � U v u�f; z � � � � � _ � ��� d �— J-_l � � 1 W � � ' O �- � , Sd�LS �--- o � ' . � � � O � � � � � � � � 1-1-� .� �.�'> 6 !.� � � r- � � O � � � � J . .. ._ ---� ` r'� �v��v -- y������ � � � � ������ � � DEPARTMENT OF PUBLIC WORKS Rich Lallier,Director CITY OF SAINT PAUL Dan Haak, Manager Telephone: 651-266-6080 Christopher B. Coleman, Mayor Street Engineering/Construction Fax: 651-292-6315 � 900 City Hall Annex . � 25 W.Fourth Street ' Saint Paul, MN 55102-1660 � The Mosc Livabia Ciry In America August 2, 2012 Joshua Aydt 679 Cherokee Avenue Saint Paul, MN 55107 RE: Property at 679 Cherokee Avenue. PIN: 072822320116 Dear Mr. Aydt: On August 1, 2012 the City of Saint Paul started performing sidewalk replacement on West Morton Street between Delaware Avenue and Cherokee Avenue. The work being performed is to replace the city sidewalk, as needed, to ensure a safe pedestrian passage along that street for citizens. While removing the existing sidewalk along the Morton Street side of your property, the retaining wall from your property fell over. The reason for the collapse appears to be the fact that the retaining wall has been pushing out over the years and had encroached over the city sidewalk. Since the retaining wall encroached onto the city sidewalk, responsibility for any repair to the wall rests with the property owner. The contractor will be removing any remaining parts of the retaining wall that interfere with the replacement of the sidewalk. If you have any further questions, please feel free to contact me either by phone 651-266-6108, or by mail at: Allan Czaia City of Saint Paul Public Works 900 CHA 25 W. 4TH St. Saint Paul, Minnesota 55112 Sincerely, ��L.L�� J a� - '_ �1 Allan Czaia Sidewalk Supervisor �Qapsive S�ryc ��`�t0 1 Q Y� 'S '"�� An A�rmative Action Egual Opportunity Employer Q. s�,N� 4 <rueiK woRics c i ��.�p' ��%yes.cme� •P.yl• .� > � ,: , "°''""'�=�., I �."��� �=/ � .. , �� ��� ' \ � I• �� �' � . , _ � �� r � � � :F ; �� /�� +� o.,. , ..~�� . 1 '� � . ... �, , �p. r — :"'"� :F „�� r�� '~' :. 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Office: 651-769-9131 Fax: 651-493-3245 I ' I I ' ' I ' � I ernestconstruction@comcast.net MN LICENSE#20468148 Proposal Submitted to Phone Date Street Phone City,State,Zip Job Location We hereby submit specifcations for: Method of Payment: ❑Visa/MC ';�1 Cash/check '� Discount $ WE PROPOSE hereby to furnish materials and labor, complete in accordance with the above specifications, for the sum of: dollars ($ ). All Material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Alterations or deviations from above specifications which become obviously necessary during construction, may result in extra charges not to exceed 20% of the contract;any other changes which result in extra charges will be executed only upon written change orders.All agreements contingent upon strikes, accidents or delays beyond our control. Owners to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workman Compensation Insurance. 4-year workmanship guarantee. PRE-LEIN NOTICE AND ACKNOWLEDGMENT Upon acceptance of this Proposal,this document becomes the Contract and Agreement between the parties,and under Minnesota State Law you are hereby further notified as follows: Any person or company supplying labor or materials for this improvement to your property may file a lien against your property if that person or company is not 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 contact price,or withhold the amounts due them 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 material for the improvement and who gave you timely notice. Note:This Proposal may be withdrawn ACCEPTANCE OF PROPOSAL-The above prices,specifi- if not accepted within 30 days cations and conditions are satisfactory and are hereby accepted.You are authorized to do the work as speci- ERNEST CONSTRUCTION fied.Payment will be made as outlined above. Signature Date By: Authorized Signature Signature Date ayea amleu6ig alea aml�u6ig �anoqe paui��no se apeu�aq-µuv��uaua�(ed �pai�i�ads s��aonn ay�op o�pazuoy�ne aae no��pa�daooe�(qaaay aae pue�(ao;�e�si}es aae s�.r`oi�ipuo�pu�suoi;e�i�i�ads'saoud anoqe ayl :��sodoad �o a�ue}da��d amlau6ig a , yIn � ..-i° . _ � , s�(ep�,diy1lm pa�daaos�ou;i sn�tq " _ ,;-.. < tf�•._. : u,v�e�PUUnn aq,(ew � . __ � f �esodad siyl:a�oN ,! � � ° � , '. � �., _ . � . ,., . 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