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Filed for Record 07/25/2017 04:44:40 PM - Kittitas County, WA Auditor - 201707250047 Page 2 of 6 <br />7. Describe in detail the defect which caused the injury: <br />veAl,"tir���dn� Vi"iv,6tow <br />8. Describe in narrative form and in detail exactly how the incident occurred: <br />10 <br />11. <br />12. <br />hey m fk 0` eCX- rSl QraveA HCl^^+j/\e- <br />e.fn n <br />0X-4 � vr-J- SL in. n AA.. •,r io <br />!� f?4, v ' � k4 -f ► t v V ' S i f/x � W y � O VNJ 1� C �t 1 '1• W CLS e!# P.t.�cl . te l c n ,f l3 -i Sp� '� CC - <br />'An, i <br />List th�r�am of a 1 persons involved an co tac mformatio , if Ycnown. <br />IM eA •-' ob 1 q . <br />Was claim investigated by a police officer? YN V <br />Sheriff State Patrol City Police <br />Description of claimant's vehicle: SOS Kl YL&- Make Year ION <br />Model: II vw tVt'L.C� License No. P HI -r- <br />- I <br />Describe what you did after the accident occurred: <br />-'1..P- vu, "Uw cLv,.k- c.�I lel <br />W(v VS "3 S D We, -VO S* 4't, +Uy vv� 100 1-) AA <br />13. Describe the conversations you had, if any, with County personnel during or after the <br />incident occurred: <br />Se -e, e S fi �v► 12- <br />2of3 <br />Kittitas County Claim for Damages Form <br />Revised 9/2012 <br />