Fitzpatrick !►�struc�ia��s� far Filinc� (Votic� of Clain� ta City af Saint Paul� ��
;:
Mri�nesota State Statute 466.05 NOT/CE OF CLAIM...(Elvery person...who claims darnages from any
municipa/ity...shal/cause To be presented to the governing body of the municrpa/ity within 180 days after the �
allec�ed loss or injury is discovered a notice srating the time, place, and ci�cumstances thereof, and the amoun2 of
compensation oi other relief demanded.
Piease complete tl�is form in its entirety by typing or printing your answer to each question in
tl�e space provided. If additional space is needed, please attach additional sheets.
...<< ._
--.� PLEASE RETURN THIS Office of City Clerk
COMPLETED FORM TO: 170 City Hall RECEIV�p
15 W I(eliogg Blvd
� St Paul MN 55102 SEP 03 2013
� ^ CITY CLERI� _..=
�_ , �-
Your Name: CJ�Q��'' ; � ��`�.�'. `
G .� �
Street Address: . 7�� � �,. � _ � _ .7 � - _
, , ; I ''��j�
City: _������,`(��� State, ; � !; � Zip Code: �;��t�-��-V
� t- -. . '
Daytime Telephone: ����)�(�<._3� }�-° Evening Telephone: ( 7�) ���- ����
Date of Accident or Incident: ��'���I���3 Day of Weel<: Time: � ���i�am or��circ�e one) ,
��.�
Please state, in detail, wfiat occurred and the circumstances surrounding the event. Indicate how the
City of Saint P ul is involved, and why you feei th City is esponsible.
�-� ,` � "
� c_.. 1� ;�„ � \ Z� ;� �4 � i
� �
� � ' �� �r 1 � .
� - � r�F � �,._ �
i �
-�u, St,. � r �
,�
� 5 h �,G M z �'
� '� r-, ,� �s .� ,�
' I�l -�- Y) .
.�.i�,�,�-,� ctr�d �b � �,� �� � np� �, h d�t�. i
Please in icate your reason or completin this form:
f:�.l Vetiicle accident f-] Other property damage (please provide specifics below) ;';,�j�
, �� ,
Vehicle was towed ;;-
:;I
❑ Vehicle damaged � Other injury to person (please provide specifics below) '�'
,,i�4
O Slipped and fell on City property
Please provide the names and telephone numbers of any City employees involved in this ; '
incident/accident and i ow tl� y were inv Ived:
�t, 1 �"q 1� '
p�� G� ,
� �� � �
('over)
If your vehicle vvas involved, as complete the following:
Year, malce, and model: � License Piate fVumber:
Extent and area damage :
Was a City vehicle involved in tliis accident/incident? Yes No (circie one)
If yes, please complete the following: Type of vehicle
Year, make, and model �
� � Color of vehicle License Plate Number: -
"�i""� Description of vehicle
Location of accident/inciclent (please provide specifics such as street address, intersection, cross streets,
park name, f cility name; etc.): � �
. ��(� �'�. Y�°�Jl,'�' S� � � '��r ,�,.
__ Please draw or attach a diagram if applicable; __ _ _ _
R
Please specify the nature and extent of tl�e compensation or other relief you are requesting. Please
attach copies of any bills, receipts, ticicets, or other documents to support your claim. If you are
claiming damage to a vehicle, p.lease submit two estimates.
� �
Were there witnesses to this accident/incident? Yes No (circle one)
� � .
If yes, please ive the names, addresses, and telephone numbers of e witnesses:
� � �� 2 �.
z-s��
� , �
Were the police called? Yes No (circle one) If yes, what department or agency? �
Police report number: "
Please print the name of the r
person completing this form: °; � ��
"�"�=?'---- - ,�.
Please sign your name: � '-�-°' �
I
Date form signed: �
�
Risk Mgmt Division - Revised 1-30-01 ;i���ji:;:
. ��`:li, �7,.'.
.. ,%a.'��i��(.!i'-
. . i
August 25, 2013
To the City of Saint Paul and Ramsey County, Minnesota,
I reside at 2127 Saint Clair Avenue in Saint Paul. My neighbors,Jacob and Alexa Fitzpatrick, informed me
that their pickup truck was towed in early August from Finn Street near the intersection of Finn Street&
Saint Clair Avenue. Jacob also informed me the reason for the ticket and tow was that the truck was
labeled as an abandoned vehicle.
I bear witness to the fact that Jacob regularly drives this green 1998 Chevrolet 3500 truck nearly every
day of the week and that the truck was not left in an abandoned state for 48 hours, or any duration of
time. Please contact me with any questions.
Sincerely,
�
_��C% -'��^% �
�
Tim Kowalewski
Email:timk .umn.edu
Phone: 206-816-5256
Address:
2127 Saint Clair Avenue �
Saint Paul, MN 55105
;;� �
�
ORens �
PIN Interssctiny Straok ST CLAIR AV
2 i3s Street:SARGENT AV
Offenss City: .
St.Paul
Permit Zone: Sipns Vis�
k^cer Number Time Zone'.
Cha�k In: Chalk Out: Parked: (HH:MM�
Unit:970
? oficer t:PEO C.Flelds
OfficsrNumbec 795910
Olficer 2: .
ORlcer Numbsc
Report defective meters by noon the next business day
Call(651)2BB-9778
To pay your flne by credit card,wait 5 business days and then call
(851)2d6�9202
If cited far No Proof of Inaurence or No Drivers Licanse in Posses3iun,Proof of Insurance and/or
Drivers Licenae should be shown in one of the Violations Bureau Locations listed below within
30 business days ofthe violation.
To payyour citation online� wv✓w.2ndwebe�courts state mn us
For additionsl information or to pay your flne by telsphone usin9 a credit card,
Ca1C (661)266-9202.
Please have your citation numbsr and credit card available
Mall paymenta to: Ramsey Districi Court
TreKc Vlolations 8uresu
16 West Ksllopy Boulsverd-Room 130
St.Paul,MN 66102-1613
MaNe checks payable to: Ramsey�istrict CouR
(A cherfle of up to 530.00 wlll be assessed on all returnad checMs)
Violations Bureau Locations
St.Paul Court Suburban Court Law Enforcement Center
15 W Kelloqp Blvtl.RM 130 2060 White Bear Ave. 426 Grovs Stre�t
St.Peul,MN 66102 Maplewootl,MN 66109 St.Paul,MN 66101
Office Hours:8:00 A.M.-4:30 P.M. Manday-Friday(Excludinp Holidays�
Hearinp ORicers�.8y appointment only tali(661)4669202
Payment and Penalties
If you wish to plead guilty for the oRense(s)on the roverse side of the citation,you must do so
within 30 days hom the dzte the citation is filed with tNe Court.It is your responsibi�ity to
present your payment n a timely menner Pleass dlow 6 business days for processiny.A 55.00
letn fee is added to all unpaid fine balantes.ARer 40 days from the dule lhu titation is flled with
the Court additional delinquent fees may be added to all unpaid flne amounts.
Additional penalties may include.1)raferral to the Depertment of Public Safety for driver's
license suspension,2)arrast warrant issued,sndlor 3)referral to a collections ayency.
If the oRensa is a petty misdemzanor,failure to appear will be considered a plea o/puilty and
waiver to lhe ripht to trial unless the failure to appear is due to circumstances beyond the
person's control{M.S.169.91).
---�------- - --�---------- -
Appeal
To plead not yuilty,or to plead puilty and oRer en explanation:
1)ARer 6 businass days,call 65L266-9202 to confirm that the citation has been flled
with the court.
2}If the citation has bzen filed,request a hearinp oRcer appointment.
3)When you arrive at the Violations Bureau,tell the cashier that you have a hearinq
o?cer appointment You must have a photolD with you.
1 understand that by PAYING THIS FINE I AM ENTERING A PLEA OF GUILTY to this oRSnse(s)
and voluntarily waive the following riyht to�
A.a trial to the court,if olFense ia a petty misdemeanor,
8.a trial to the ceurt or to ajury i/ths oRenss is a misdemaanor,
C.representation by counsel,
D.a presumption o/i�nocence until proven fluilty beyond a reasonable doubt,
E.confront and cross-examine all witnesaes apainst me,and
F.elther remain silont or to testliy in my own behalf.
I also undefstend that if this offense is a petty misdemaanor,the maximum possible ssntence is
s300.00,if this oRensa is a misdemeanor,the maximum possible sentence is 51 000 00 fine
andlor 90 deys Imprlsonment.
Citation No.:620900516639
�.
�
�
y
1
' " . ._. . . '�rYU.au....��
�„�.._.
_-____��— —_-
� e Impound Lot, 830 Barge Channel Road, Vehicle Release Form
83Fi BAR(iE GHAN5N51L�R2950
SpINT pAUL�.MN� _ET License#: YAD5045 CN: 13167853 Invoice#: 145807
651-166 5642
gvf063fs6144 : O$IOHIZO�3 Z�:�JZ Tow Charge: $ 54.50 '
Merohant e01�.34�aa089y638014408
Term ID•
SalE Storage Charge: $ 0.00
zzxxzzzxzzx1005 Entrv Method; Saiped �p Admin Charge: $ 80.00
pMEX � 144,16
Total� Tax: (7.625%) $ 10.26
21;52:46
ggr08�13 Appr Code� �1184 recovered the vehicle described above. Subtotal: $ 144.76
jpy�; Q�0012 `or damage or any other problems that
ApArvd� Online e this vehicie was in the custody of the Service Charge: $ 0.00
c�sto„��� G°"r tment. I acknowledge I will report
�har+K vo�' r problems to the Impound Lot staff Total Charges: $ 144.76
. N,,,,� �,, ieaving the impound lot.
Damage and/or other problem:
Police Report made: Yes_No,_IF Yes, CN , If NO, Why?
TO PROTECT YOUR RIGHTS REPORT ANY PROBLEMS/DAMAGE BEFORE LEAVING THE LOT
Signature 5/2000