Arnold, Matthew
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 this completed form to the
mailto:Saint%20Paul%20City%20Clerk’s%20OfficeSaint Paul City Clerk’s Office by email (cityclerk@ci.stpaul.mn.us), fax (651-266-8574) or mail addressed to “Saint Paul City Clerk, 15 West
Kellogg Blvd., Suite 310, Saint Paul, MN 55102”.
Claimant: First Name: _____Matthew_____ Last Name: ____Arnold__________________________________
Please Indicate Your Pronouns: ☐ She/Her/Hers, ☒ He/Him/His, ☐ They/ Them/Theirs
Company or Business Name: ___n/a_________________________________________________________________________________
Is this claim being made by an Insurance Company? NO If yes, what is your Claim/File Number? <_________________________
Is this claim being made by an Attorney? NO If yes, what is your File Number? _______________________________________
If yes, provide your Insured’s/ Client’s Name: _______________________________________________________________________
</
Street Address: ___1847 Stanford Avenue_______________________________________________________________________
City: _________Saint Paul_________________________ State: ______MN__________ Zip Code: ___55105__________
Daytime/Work Phone: __(651)983-4180___________________ Cell Phone: ___(314)306-4128________________________
Date of Incident or Date Discovered (Must Complete): 7/26/2023 Time: early AM storms; discovered at 6AM
Please state, in detail, what happened that prompted you to file a Notice of Claim Form: Heavy wind and rain storm in early AM hours of 07/26/23 caused a defective city boulevard tree
on the eastern side of the 200 block of Howell St. S. to split at an entangled, weakened junction of three branches. Large limb fell westward onto our property, 1847 Stanford Avenue.
The limb pulled the main Xcel power line to the ground, which remained active, while simultaneously pulling away the mast and destroying the console that houses the power meter. Xcel
Energy was called immediately upon discovering the situation. Their response was delayed, as power was still intact and no fire was present. A call was submitted to the city regarding
the tree and required the lines to be disconnected first. In the meantime, multiple crews and an arborist were dispatched to inspect the tree, which was found to be defective and at
risk for further damage, along with the same type of tree on the western side of Howell St. S., which was emergent in nature and required prompt remediation/removal. These trees had
not been cared for or identified as at risk, even though tree surveyors were in our neighborhood in Spring 2023.Consultations for repair were solicited from several private electricians,
all of whom stated Xcel first needed to shut off main power to temporarily post the lines and then repairs between main and home could be performed. On 7/30/23 the Saint Paul Fire Department
was called by an unknown neighbor, concerned about the situation and lack of attention. The FD reported the situation to Xcel, who subsequently attended to the home that evening approximately
8pm, followed by Saint Paul Forestry. A private electrician, Nu Electrical Co., was able to make arrangements to repair power damage caused by the limb and restore power to home.
Please state why or how you feel the City of Saint Paul is responsible for your Damages? Boulevard tree was not in good health and care had been neglected by City of Saint Paul. This
tree could not sustain wind/rain properly due to lack of care/proper trimming and caused damage to the property. Additionally, in July 2023 an email was sent from our household concerning
the health of this tree, as it seemed abnormally drooping and was dropping excessive amount of sap compared to previous summers. The limbs had seemed overburdened compared to other tree
of same variety on our side of the boulevard and I was worried about an infestation of insects exacerbating weaknesses. The concern was dismissed without any experts or arborists coming
to investigate the state of the tree. Had an expert been dispatched to our house after spring survey or earlier in July 2023, concerns would have been raised regarding the structure
and health of the tree. The same situation that arose upon inspection after our incident with the tree across the street, which was immediately removed due to structural integrity issues.
The tree may have even been spared with proper care. Instead, the deficient tree was exploited by the storm and required us to pay for the damage.
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.
☐ 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. **see attached**
☐ 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.
Continue to page 2 of Notice of Claim Form. Failure to complete and return both pages will result in delays.
This section must be completed for all claims.
Is there a police report for this incident? NO
If yes, please provide the police report case number: ___________________________
If yes, what law enforcement agency responded? * Saint Paul Fire Department was called and made submission to Xcel
Where did the incident take place? Please provide a street address, intersection or name of city park or facility:
Backyard of 1847 Stanford Avenue, Saint Paul, MN 55105
What would you like to see happen to resolve this claim to your satisfaction? __City of Saint Paul to reimburse full amount of private electrician invoice, as attached with submission.
$3100.
Were there witnesses to this incident? Please provide names and contact phone numbers: </w:t></w:r></w:sdtContent></w:sdt><w:r w:rsidR="0031571E" w:rsidRPr="00 Katie Arnold (651)983-4180
For property damage claims, including vehicle accidents.
Your vehicle’s information: Year: _________ Make: _________________ Model: __________________ Color: __________________
License Plate #: _________________________ State vehicle is registered in: ___________________________
Registered owner of vehicle: _____________________________ Driver: __________________________________________
Area(s) damaged:______________________________________________________________________________________
If a City vehicle was involved, License Plate #: _________________________________ Color: _______________________________
Was there City insignia on the vehicle? YES / NO Driver’s Name</w: ______________________________________________________
Other property damaged: _As described above; electrical unit on outside of home at 1847 Stanford Avenue
For injury claims of any type. <
What part of your body was injured? n/a
Did you go to the emergency room or urgent care? YES / NO Where? ___________________________________________________
Was medical treatment received? YES / NO Where? </________________________________________________________________
First day of medical treatment? _____________ Are you still receiving medical treatment? YES / NO
Did you miss any work as result of this incident? YES / NO <
Employer(s): _________________________________________________________________________________________________
How much time have you missed from work? _____________________________________________________________________
If you are submitting other documents, please state what you are attaching and how many pages: Emails sent to city regarding tree concerns in July 2023 (1 page); invoice from Nu Electrical
(1 page)
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: Kathryn Therese Arnold <
Signature of Person submitting this form: Kathryn Therese Arnold (electronic)
Relationship of person signing to Party making the claim: Spouse
Date document is being signed: 8/21/2023
Revised March 2023