Laserfiche WebLink
Filed for Record 01/06/2011 03:45:29 PM - Kittitas County, WA Auditor - 201101060034 Page 2 of 6 <br />Describe in detail the defect which caused the injury: . 'e <br />8. Describe in narrative form and in detail exactly how the incident occurred: <br />S' <br />9. Was claim investigated by a police officer? MO <br />Sheriff State Patrol City Police <br />10. Description of claimant's vehicle: e• l.,Make Year <br />v <br />Model License N <br />11. Describe what you did after the accident occurred: vi cir 4n64 6 <br />ST r <br />12. Describe the conversations you had, if any, with County personnel during or after the <br />incident occurred: o / D 4 T <br />13. Describe the damages or injuries which you sustained as a result of the incident: Ao.s u 1%rSM A j <br />4;r eSTirnAre Ar- 4 Y.2 tfnd jr'v .r- 6usT3 es Ti F 4"r OF <br />As,/-.r+Y.d.lut Pwale-M,)ulnl A-r-rWuf 77,"e- 4oa.S v,,d'VHtle Ofleov <br />.�y3 Kul F1�Tj" /1►�n/tM /FN :f r,��j �i/oQ is t �NN+�N�xv�% A7- 11-A0 7%171 a .. <br />14. What is the amount of damages claimed? {Include estimates and bills, if available}: <br />.SiEz +// a�J�F� X"," 4bej A/t dll, i' �CnI�� ✓�i! �j�1 T /NL�irr41 <br />15. How did you identify the County as the party responsible for your damage? <br />-S AIMICkEA <br />Page 2 of 3 <br />