Kangas, MelissaThink Before You Click: This email originated outside our organization.
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 municipality…shall cause to be presented to the governing body of the municipality within 180 days
after the alleged loss or injury is discovered a notice stating the time, place, and circumstances thereof, and the amount of compensation or other relief demanded.”
Please complete this form in its entirety by clearly typing or printing your answers to each question. If you have additional documentation you may add those documents to your submission.
You will not be contacted by telephone unless clarification is needed. The claim process for investigations can take upwards of four (4) weeks. This form must be signed, dated with
all applicable sections completed. Submission is to the Saint Paul City Clerk’s Office <https://www.stpaul.gov/departments/city-clerk> . You may email <mailto:cityclerk@ci.stpaul.mn.us>
, fax (651-266-8574) or mail the form. Mailing address is “Saint Paul City Clerk, 15 West Kellogg Blvd., Suite 310, Saint Paul, MN 55102”
Individuals: First Name MELISSA Last Name KANGAS _____________________________________________
Please Indicate Your Pronouns: She/ Her/Hers __x____ He/Him/His ______ They/ Them/Theirs _______
Company or Business Name: ______________________________________________________________________________
Is this claim being made by an Insurance Company? ____ If yes, what is your Claim/File Number?: _____________________
Is this claim being made by an Attorney? _________ If yes, what is your File Number? _______________________________
If yes, then provide your Insured’s/ Client’s Name ____________________________________________________________
Street Address: 1254 TAYLOR AVE W
City: ST. PAUL State MN Zip Code 55104
Cell Phone 651-336-0291
Date of Incident or Date Discovered (Must complete) 2/01/23 was incident but discovered on 20/03/23 Time 7:30 am
Please state, in detail, what happened that prompted you to file a Notice of Claim Form. I was bringing my car home from the tiresplus of Snelling Ave. I had a bead leak repaired and
another tire replaced. I take hamline home and there are potholes everywhere from target all the way to my street Taylor ave. It was probably the bigger ones that were now only recently
filled after i reported them to the pot hole email. I went to take it to work Friday morning after picking it up Wednesday to find that my right tire was going flat again. I brought
it back to tires plus where they found a new crack in my rim. (that rim was only 4 years old) that was not there two days prior. That means those potholes on hamline street I take
almost daily damaged my rim.
______________________________________________________________________________________________________
Please state why or how you feel the City of Saint Paul is responsible for your Damages? There are so many potholes in the city of St. Paul. Hamline is just one example. And again after
I reported them they started getting filled. They are unavoidable sometimes when there is traffic and cars parked everywhere. I have already had to replace a rim in the past due to potholes
and I should not be liable for something out of my control that causes me to lose more money by having to purchase another rim. Rims can last the life of the vehicle unless you get into
an accident or hit potholes.i have been in no accidents and I cannot change where or live or control the roads. I think St. Paul should be liable for the cost of the rim I just had to
replaced.
Please check the reason that most closely describes the reason for your submitting a claim. Please note the documents that will need to be provided with your completed form. Photographs
will be accepted. All documents submitted become the property of the City of Saint Paul and shall not be returned.
___ Automobile damage from a motor vehicle accident: please provide two estimates for repairs or actual bill that has been paid.
__X_ Automobile damage from a street defect or pothole : please provide two estimates for repairs or actual bill that has been paid.
___Automobile was towed and may or may not have sustained damage: please provide copy of towing ticket (if available), receipt from Impound Lot, and two estimates for repairs or actual
bill that has been paid.
___Snow Emergency: please provide copy of towing ticket (if available), receipt from Impound Lot, and two estimates for repairs or actual bill that has been paid.
___Property damage: please provide two estimates for repairs or actual bill that has been paid.
___You were injured during a motor vehicle accident: please provide police report number, details about injury.
___You were injured in the City of Saint Paul: please provide police report number, witnesses and details about injury.
This section must be completed for all claims.
Is there a police report for this incident? Yes No If yes, please provide the police report case number ____________________
Revised December 2021
Notice of Claim Form, page two. Failure to complete and return both pages will result in delays.
If yes, what law enforcement agency responded? _______________________________________________________
Where did the incident take place? Please provide a street address, intersection or name of City park or facility.
Hamline Ave near Thomas intersection
What would you like to see happen to resolve this claim to your satisfaction? I sent an invoice in prior email. Reimbursement from the city.
Were there witnesses to this incident? Please provide names and contact phone numbers. The invoice I sent in prior email has notes from mechanic who has been working on my car.
For property damage claims, including vehicle accidents.
Your vehicle’s information: Year 2007 Make Buick Model lucerne Color white
License Plate # JGF466 State vehicle is registered in Minnesota
Registered owner of vehicle Melissa Kangas Driver Melissa kangas
Area(s) damaged Right rim from pothole
_
If you are submitting other documents, please state what you are attaching and how many pages. I have sent the invoices in prior email before I got the claim form
By signing this form, you agree that all information provided is true and correct to the best of your knowledge. Please NOTE that submitting a false or misleading claim can and will
result in prosecution under Minnesota Statutes.
Name of Person completing form: _Melissa Kangas
Relationship of person signing to Party making the claim: myself
Date document is being signed _2/15/23
Signature of Person submitting this form: melissa kangas
Revised December 2021
On Wednesday, February 15, 2023 at 09:31:01 AM CST, Naylor, Racquel (CI-StPaul) <racquel.naylor@ci.stpaul.mn.us> wrote:
I’m sorry.
The claim forms are attached. Please complete either one. They are basically the same.
Thank you.
Racquel Naylor
Saint Paul City Council
Suite 310 City Hall
15 Kellogg Boulevard West
Saint Paul, MN 55102
Phone: 651-266-8573
Fax: 651-266-8574
From: Melissa kangas <melissa_kangas@yahoo.com>
Sent: Wednesday, February 15, 2023 9:19 AM
To: Naylor, Racquel (CI-StPaul) <racquel.naylor@ci.stpaul.mn.us>
Subject: RE: Potholes on hamline
Think Before You Click: This email originated outside our organization.
I see no claim form anyhwere. All i was given was your email.
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On Tue, Feb 14, 2023 at 1:16 PM, Naylor, Racquel (CI-StPaul)
<racquel.naylor@ci.stpaul.mn.us <mailto:racquel.naylor@ci.stpaul.mn.us> > wrote:
Did you already complete a claim form?
Racquel Naylor
Saint Paul City Council
Suite 310 City Hall
15 Kellogg Boulevard West
Saint Paul, MN 55102
Phone: 651-266-8573
Fax: 651-266-8574
From: Melissa kangas <melissa_kangas@yahoo.com <mailto:melissa_kangas@yahoo.com> >
Sent: Tuesday, February 14, 2023 1:13 PM
To: Naylor, Racquel (CI-StPaul) <racquel.naylor@ci.stpaul.mn.us <mailto:racquel.naylor@ci.stpaul.mn.us> >
Subject: Potholes on hamline
Think Before You Click: This email originated outside our organization.
Hello i spoke with someone a few weeks ago and finally got my rim today. I also accidentally deleted the pictures of the pothole but the thing is you guys already filled them so I believe
that should be proof enough they existed... this is my SECOND rim on the same wheel. I purchased tires and a new rim in 2019. And here i am again having to replace a barely used rim
because of potholes. Again you guys just filled multiple potholes off hamline up and down near target and by my neighborhood. My current address is 1254 Taylor ave W. St. Paul. And i
also can't avoid the potholes on 280 when going to work. A rim can often last the life a vehicle unless you get into accidents or potholes. Never been in an accident. Not to mention
the terrible icy roads by me. As you can see from the receipts i went in and they repaired my tire and then I drove my car home and days later my tire was going flat and that's when
i brought it back and they found the crack. I had to get a used rim shipped because i can't afford a 300 dollar rim. I aways have to use hamline to get to places and with cars parked
every its hard to avoid them all. Again you guys already filled them and im sure you can look it up. The pothole on hamline near the coffee shop. If you really need to me take a picture
of the pothole you guys filled there I can but I think this is all proof enough that city should at least reimburse for the rim.
Thanks for your time.
Melissa kangas
651 336 0291
1254 Taylor ave W.
St. Paul MN 55104
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