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V Filed for Record 11/15/2017 03:47:58 PM - Kittitas County, WA Auditor -201711150066 Page 2 of 8 <br />7. Describe in detail the defect which caused the injury: <br />ji)lIY �rym ,z_ o!�E J� ea. -h -o � Ve-hi`G: cs GSCt cion �l L:-, <br />61 <br />S�2cr1c, UY�r, �1i?""�1'n.G �'ha- ��IV�ySldae i��✓ C�1rnPv pav�Q.l <br />Imu (ar. <br />8. Describe in narrative form and in detail exactly how the incident occurred: <br />I WaS yLaf- ,�reSen7 p w, eSS -�Ke et661 f9i MV Gam iJGtS <br />a,! aS tiJ tsYk, rt,�, <br />9. List the names of all persons involved and contact information, if known. <br />10. Was claim investigated by a police officer? Ye 5 <br />Sheriff( State Patrol City Police <br />11. Description of claimant's vehicle: Do ria -e Make `� � � Year <br />Model: C -,a j c.en ce r License No. S'/v97 4F`iZ R <br />12. Describe what you did after the accident occurred: <br />i�'e.0�ctti t"73slcr C2 i1 c( �Cf/>7 nL�Pt� LJec f)c�'rte <br />13. Describe the conversations you had, if any, with County personnel during or after the <br />incident occurred: <br />i;M n -701n dei l��`c,Grs/� +�r yvt,( f) -,g C✓%ia <br />2 of 3 <br />Kittitas County Claim for Damages Form <br />Revised 9/2012 <br />