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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 />SVVVr'ii cVr,°sr�Ded 43bDOI V�')nO{t0�n� <br />8. Describe in narrative form and in detail exactly how the incident occurred: <br />weI- of Nokllg�,m (LOie d1 QY�yeilg� II�e- c%V <br />C&N ivy 4Yl�-r 1" 6k V)A0 nk.x fa ,•� ICKA 1,s 6xk2.,A) AiJ <br />���-- t�� r wr.S c <br />f�iPQtN�M W1 c'N. �L 1 <br />(t 19 ye8 � erhei . V ••}Md a dl`co LM '*b'i-1 % S pYeolwn. <br />9. List th0 riam of a persons involved an cordtact mformatioIl, if known. <br />inntnCedF c�1-,iv, . <br />r <br />10. Was claim investigated by a police officer? In U <br />Sheriff State Patrol City Police <br />11. Description of claimant's vehicle: SAO VY ti Make Imeves1 -A. Year ION <br />Model: 1ytn pq -Z C. License No. A VAP 3+5-3- <br />12, <br />7T - 3 <br />12. Describe what you did after the accident occurred: <br />I�n�.ie �np�yo t C,.CS�,S�rQ -i�ln2 w�t�pR-l)w 0..v Grillp�i <br />aoblr WadV� `3 SOoY.�`1ti �71n�1� w`1no czdvtirdd� •�'1-e�uyw, lc(,a'htSV� <br />13. Describe the conversations you had, if any, with County personnel during or after the <br />incident occurred: <br />CP -P- !A rtv4 ren 12• <br />2of3 <br />Kittitas County Claim for Damages Form <br />Revised 912012 ,. <br />